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Infant-Mother Attachment Can Be Improved through Group Intervention: A Preliminary Evaluation in Spain in a Non-Randomized Controlled Trial

Published online by Cambridge University Press:  10 January 2013

Bárbara Torres*
Affiliation:
Universidad del País Vasco (Spain)
Itziar Alonso-Arbiol
Affiliation:
Universidad del País Vasco (Spain)
María José Cantero
Affiliation:
Universidad de Valencia (Spain)
Amina Abubakar
Affiliation:
Tilburg University (The Netherlands)
*
Correspondence concerning this article should be addressed to: Bárbara Torres, Facultad de Psicología, Universidad del País Vasco, 20018 San Sebastián (Spain). Phone: +34-943018317. E-mail: [email protected]

Abstract

The quality of infant-mother attachment has been linked to competence in different domains of child development. Research indicates that early intervention can enhance the quality of infant-mother attachment, though its efficacy in a group format has yet to be evaluated. The current study is aimed at examining the usefulness of a group intervention in enhancing infant-mother attachment. An intervention aimed at addressing aspects such as maternal responsivity, sensitivity and childrearing behaviour was developed by the researchers and experienced psychologists. The intervention spanned a period of 14 months starting from the third quarter of pregnancy. The intervention was evaluated among 24 mothers from the Basque region of Spain. The sample consisted of children of both genders in a similar proportion: 45.8% were boys and 54.2% were girls. The children in this sample were full-term born and did not present symptoms of any serious pre- or postnatal complications. The intervention had a statistically non-significant medium effect. Infants whose mothers had received the intervention showed higher rates of secure attachment compared to children from the control group, as assessed by the Strange Situation observation procedure. A potentially significant confounding variable, maternal attachment, was balanced across the intervention and comparison groups. We can tentatively point out that a group intervention may enhance the quality of infant-mother attachment. Nevertheless, because the study design was not randomized, the results of this study remain preliminary and need replication in a full randomized controlled trial designed study.

La calidad del apego bebé-madre ha sido asociada a la competencia en diferentes dominios del desarrollo infantil. La investigación muestra que la intervención temprana puede mejorar la calidad del apego infante-madre, aunque su eficacia en formato grupal no ha sido todavía suficientemente evaluada. El presente estudio se dirige a examinar la utilidad de una intervención grupal en la mejora del apego del bebé hacia su madre. Esta intervención ha sido desarrollada por las investigadoras y otras psicólogas expertas, y está dirigida a abordar aspectos tales como la responsividad, la sensibilidad y la conducta de crianza de las madres. La intervención tuvo lugar durante un periodo de 14 meses, comenzando desde el tercer cuatrimestre del embarazo. La intervención fue evaluada en 24 madres del País Vasco (España). La muestra estaba formada por bebés de ambos géneros en proporción similar: 45,8% eran niños y 54,2% eran niñas. Los niños de esta muestra eran nacidos a término y no presentaban ningún síntoma de complicaciones pre- o postnatales serias. La intervención tuvo un efecto medio estadísticamente no significativo. Los bebés cuyas madres habían recibido la intervención mostraron tasas más altas de apego seguro en la Situación Extraña que los bebés de las madres del grupo control. El modelo mental de apego de las madres, como potencial variable extraña, estaba equilibrado en los grupos de intervención y comparación. Podemos señalar de forma tentativa que una intervención grupal puede fomentar el apego seguro del bebé hacia su madre. Sin embargo, debido al carácter no aleatorio del diseño, los resultados de este estudio son preliminares y necesitan una replicación a través de un estudio con un diseño controlado aleatorizado.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2011

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References

Ainsworth, M. D., Blehar, M. C., Waters, E., & Wall, S. (1978). Patterns of attachment: Assessed in the Strange Situation and at home. Hillsdale, NJ: Erlbaum.Google Scholar
Bakermans-Kranenburg, M. J., van IJzendoorn, M. H., & Juffer, F. (2003). Less is more: Meta-analyses of sensitivity and attachment interventions in early childhood. Psychological Bulletin, 129, 195215. doi:10.1037/0033-2909.129.2.195CrossRefGoogle ScholarPubMed
Barlow, J., & Svanberg, P. O. (2009). Keeping the baby in mind. In Barlow, J. & Svanberg, P. O. (Eds.), Keeping the baby in mind: Infant mental health in practice (pp. 114). New York, NY: Routledge/Taylor & Francis Group.CrossRefGoogle Scholar
Berlin, L. J. (2007). Interventions to enhance early attachments. In Berlin, L. J. Ziv, Y. Amaya-Jackson, L., & Greenberg, M. T. (Eds.), Enhancing early attachments. Theory, research, intervention, and policy (pp. 333). New York, NY: The Guildford Press.Google Scholar
Berlin, L. J., Zeanah, C. H., & Lieberman, A. F. (2008). Prevention and intervention programs for supporting early attachment security. In Cassidy, J. & Shaver, P. R. (Eds.), Handbook of attachment. Theory, research, and clinical applications (2nd ed.), (pp. 745761). New York, NY: The Guilford Press.Google Scholar
Brisch, K. H., Bechinger, D., Betzler, S., & Heinemann, H. (2003). Early preventive attachment-oriented psychotherapeutic intervention program with parents of a very low birthweight premature infants. Attachment and Human Development, 5, 120135. doi:10.1080/1461673031000108504CrossRefGoogle Scholar
Cantero, M. J. (2003). Intervención temprana en el desarrollo afectivo [Early intervention in the affective development]. In Gómez-Artiga, A. Viguer, P., & Cantero, M. J. (Eds.), Intervención temprana: Desarrollo óptimo de 0 a 6 años [Early intervention: Optimal development from 0 to 6 years] (pp. 175203). Madrid, Spain: Pirámide.Google Scholar
Cerezo, M. A., Cantero, M. J., & Alhambra, M. S. (1997). La mejora de la competencia parental en la prevención del maltrato [The improvement of parental competence in the prevention of maltreatment]. Infancia y Aprendizaje, 80, 99110. doi:10.1174/021037097761396199CrossRefGoogle Scholar
Cerezo, M. A., Dolz, L., Pons-Salvador, G., & Cantero, M. J. (1999). Prevención de maltrato de infantes: evaluación del impacto de un programa en el desarrollo de los niños [Prevention of infant maltreatment: Evaluation of the impact of a programme in child development]. Anales de Psicología, 15, 239250.Google Scholar
Cerezo, M. A., Pons-Salvador, G., & Trenado, R. (2008, September). Child abuse potential and quality of mother-child attachment in the context of a community based prevention program. Paper presented at the XVIIth ISPCAN International Congress on Child Abuse and Neglect. Hong Kong, China.Google Scholar
Cerezo, M. A., Trenado, R., & Pons-Salvador, G. (2009). Prevención del maltrato infantil. El apoyo a los padres y sus relaciones con los hijos y el fomento de las buenas prácticas [Prevention of child maltreatment. Support for parents and their relations with children and the promotion of good practice]. In Gómez-Bengoechea, B. (Ed.), Violencia intrafamiliar: hacia unas relaciones familiares sin violencia [Intra-family violence: Toward family relations without violence] (pp.6190). Madrid, Spain: Instituto Universitario de la Familia de la Universidad Pontificia de Comillas.Google Scholar
Cicchetti, D., Rogosch, F. A., & Toth, S. L. (2006). Fostering secure attachment in infants in maltreating families through preventive interventions. Development and Psychopathology, 18, 623649. doi:10.1017/S0954579406060329CrossRefGoogle ScholarPubMed
Cooper, G., Hoffman, K., Powell, B., & Marvin, R. S. (2007). The Circle of Security intervention: Differential diagnosis and differential treatment. In Berlin, L. J. Ziv, Y. Amaya-Jackson, L., & Greenberg, M. T. (Eds.), Enhancing early attachments. Theory, research, intervention, and policy (pp. 125151). New York, NY: The Guilford Press.Google Scholar
Cunningham, C. E., Bremner, R., & Boyle, M. (1995). Large group community-based parenting programs for families of preschoolers at risk for disruptive behavior disorders: Utilization, cost effectiveness, and outcome. Journal of Child Psychology and Psychiatry, 35, 11411159. doi:10.1111/j.1469-7610.1995.tb01362.xCrossRefGoogle Scholar
Cunningham, C. E., Davis, J. R., Bremner, R., Dunn, K. W., & Rzasa, T. (1993). Coping modeling problem solving versus mastery modeling: Effects on adherence, in-session process, and skill acquisition in a residential parent training program. Journal of Consulting and Clinical Psychology, 61, 871877. doi:10.1037/0022-006X.61.5.871CrossRefGoogle Scholar
Cyr, C., Euser, E. M., Bakermans-Kranenburg, M. J., & van IJzendoorn, M. H. (2010). Attachment security and disorganization in maltreating and high-risk families: A series of meta-analyses. Development and Psychopathology, 22, 87108. doi:10.1017/S0954579409990289CrossRefGoogle ScholarPubMed
DeKlyen, M., & Greenberg, M. T. (2008). Attachment and psychopathology in childhood. In Cassidy, J. & Shaver, P.R. (Eds.), Handbook of attachment. Theory, research, and clinical applications (2nd ed.) (pp. 637665). New York, NY: The Guilford Press.Google Scholar
Dozier, M., Stovall-McClough, K. C., & Albus, K. E. (2008). Attachment and psychopathology in adulthood. In Cassidy, J. & Shaver, P. R. (Eds.), Handbook of attachment. Theory, research, and clinical applications (2nd ed.) (pp. 718744). New York, NY: The Guilford Press.Google Scholar
Dozier, M., Libdhiem, O., & Ackerman, J. P. (2007). Attachment and biobehavioral catch-up: An intervention targeting empirically identified needs of foster infants. In Berlin, L. J., Ziv, Y. Amaya-Jackson, L., & Greenberg, M. T. (Eds.), Enhancing early attachments. Theory, research, intervention, and policy (pp. 178194). New York, NY: The Guilford Press.Google Scholar
Egeland, B., & Erickson, M. F. (2004). Lessons from STEEP: linking theory, research, and practice for the well-being of infants and parents. In Sameroff, A. McDonough, S. C., & Rosenblum, K. L. (Eds.), Treating parent-infant relationship problems: Strategies for intervention (pp. 213242). New York, NY: The Guilford Press.Google Scholar
Egeland, B., Weinfield, N. S., Bosquet, M., & Cheng, V. K. (2000). Remembering, repeating, and working through: Lessons from attachment-based intervention. In Osofsky, J. & Fitzgerald, H. E. (Eds.), WAIMH handbook of infant mental health. (Vol. 4; pp. 3589). New York, NY: Wiley.Google Scholar
George, C., Kaplan, N., & Main, M. (1985). The Adult Attachment Interview. Unpublished manuscript. Berkeley, CA: University of California.Google Scholar
Greenberg, M. T. (2007). Enhancing early attachments: Synthesis and recommendations, for research, practice, and policy. In Berlin, L. J. Ziv, Y. Amaya-Jackson, L., & Greenberg, M. T. (Eds.), Enhancing early attachments. Theroy, research, intervention, and policy (pp.327343). New York, NY: The Guilford Press.Google Scholar
Heinicke, C. M., Fineman, N., Ponce, V. A., & Guthrie, D. (2001). Relationship based intervention with at-risk mothers: Outcome in the second year of life. Infant Mental Health Journal, 22, 431462. doi:10.1002/imhj.1010CrossRefGoogle Scholar
Hesse, E. (2008). The Adult Attachment Interview. Protocol, method of analysis, and empirical studies. In Cassidy, J. & Shaver, P.R. (Eds.), Handbook of attachment. Theory, research, and clinical applications (2nd ed.) (pp. 552598). New York, NY: The Guilford Press.Google Scholar
Juffer, F., Bakermans-Kranenburg, M. J., & van IJzendoorn, M. H. (Eds.), (2008). Promoting positive parenting: An attachment-based intervention. New York, NY: Taylor & Francis Group/Lawrence Erlbaum Associates.Google Scholar
Kobak, R., Cassidy, J., Lyons-Ruth, K., & Ziv, Y. (2006). Attachment, stress, and psychopathology: A developmental pathways model. In Cicchetti, D. & Cohen, D. J. (Eds.), Developmental psychopathology. Volume 1, Theory and Method (2nd edition) (pp. 333369). New York, NY: John Wiley and Sons.Google Scholar
Marvin, R. S., Cooper, G., Hoffman, K., & Powell, B. (2002). The Circle of Security project: Attachment-based intervention with caregiver-preschool child dyads. Attachment and Human Development, 1, 107124. doi:10.1080/14616730252982491CrossRefGoogle Scholar
Niccols, A. (2008). “Right from the Start”: Randomized trial comparing an attachment group intervention to supportive home visiting. Journal of Child Psychology and Psychiatry, 49, 754764. doi:10.1111/j.1469-7610.2008.01888.xCrossRefGoogle ScholarPubMed
Olds, D. L. (2007). The nurse-family partnership: Foundations in attachment theory and epidemiology. In Berlin, L. J. Ziv, Y., Amaya-Jackson, L., & Greenberg, M. T. (Eds.), Enhancing early attachment. Theory, research, intervention, and policy (pp. 217249). New York, NY: The Guilford Press.Google Scholar
Parr, M., & Joyce, C. (2009). “First steps in parenting”: Developing nurturing parenting skills in mothers and fathers in pregnancy and the postnatal period. In Barlow, J. & Svanberg, P. O. (Eds.), Keeping the baby in mind: Infant mental health in practice (pp. 5262). New York, NY: Routledge/Taylor & Francis Group.Google Scholar
Rea, L. M., & Parker, R. A. (1992). Designing and conducting survey research. San Francisco, CA: Jossey-Bass.Google Scholar
Rutter, M. (1985). Resilience in the face of adversity: Protective factors and resistance to psychiatric disorder. British Journal of Psychiatry, 147, 598611. doi:10.1192/bjp.147.6.598CrossRefGoogle ScholarPubMed
Sroufe, L. A. (2000). Early relationships and the development of children. Infant Mental Health Journal, 21, 6774. doi:10.1002/(SICI)1097-0355(20001/04)213.0.CO;2-2>CrossRefGoogle Scholar
Svanberg, P. O. (2009). Promoting a secure attachment through early screening and interventions: A partnership approach. In Barlow, J. & Svanberg, P. O. (Eds.). Keeping the baby in mind: Infant mental health in practice (pp. 100114). New York, NY: Routledge/Taylor & Francis Group.Google Scholar
Thabane, L., Ma, J., Chu, R., Cheng, J., Ismaila, A., Rios, L. P., … Goldsmith, C. H. (2020). A tutorial on pilot studies: The what, why and how. BMC Medical Research Methodology, 10, 1. doi:10.1186/1471-2288-10-1Google Scholar
Trenado, R., Pons-Salvador, G., & Cerezo, M. A. (2009). Protecting the families: Support and assistance for families. Papeles del Psicólogo, 30, 2432.Google Scholar
van IJzendoorn, M.H. (1995). Adult attachment representations, parental responsiveness, and infant attachment: A meta-analysis on the predictive validity of the Adult Attachment Interview. Psychological Bulletin, 117, 387403. doi:10.1037/0033-2909.117.3.387CrossRefGoogle ScholarPubMed
van IJzendoorn, M. H., & Bakermans-Kranenburg, M. J. (2010). Invariance of adult attachment across gender, age, culture, and socioeconomic status? Journal of Social and Personal Relationships, 27, 200208. doi:10.1177/0265407509360908CrossRefGoogle Scholar
Yalom, I. D. (1985). The theory and practice of group psychotherapy (3rd ed.). New York, NY: Basic Books.Google Scholar