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Behavioral parent training is an evidence-based intervention for children with attention-deficit/hyperactivity disorder (ADHD), but knowledge on the differential effects of behavioral techniques for specific subgroups of children is very limited. Attachment representations of children with ADHD may affect how receptive children are to changes in parenting. In this study, we investigated whether specific behavioral techniques were more or less effective for children with ADHD in relation to their attachment representations. We included parents of 74 children with ADHD (4–11 years, M = 8.15) who took part in a larger randomized controlled microtrial in which they were randomized to a two session training in antecedent-based techniques (i.e., stimulus control techniques: rules, instructions; n = 26), a two session training in consequent-based techniques (i.e., contingency management techniques: praise, rewards, ignoring; n = 25) or a waitlist control condition (n = 23). We examined whether attachment representation moderated the effectiveness of a) training versus waitlist, and b) antecedent- versus consequent-based techniques. Attachment representations were measured with a story stem task, the intervention outcome was daily parent-rated problem behaviors of the children. Attachment representation did not moderate the effects of the training compared to the waitlist. However, compared to antecedent-based techniques, consequent-based techniques were less effective for more securely and less disorganized attached children, and particularly effective for more disorganized attached children. This was the first study examining attachment as a moderator of behavioral techniques for ADHD. If replicated, the findings of this study can be used for treatment development and tailoring.

Maternal sensitivity to infant distress is a key predictor of infant attachment security and social-emotional development. Preventive interventions that support mothers' sensitive responses to infant distress are crucial, as are rigorous evaluations that test

In the current study, we evaluated the extent to which mothers reported emotion dysregulation on the Difficulties with Emotion Regulation Questionnaire (DERS) (a) converged with physiological indices of emotion dysregulation while parenting, (b) correlated with maternal sensitivity, and (c) predicted infant attachment disorganization and behavior problems in a sample of 259 mothers and their infants. When infants were 6 months old, mothers' physiological arousal and regulation were measured during parenting tasks and mothers completed the DERS. Maternal sensitivity was observed during distress-eliciting tasks when infants were 6 and 14 months old. Infant attachment disorganization was assessed during the Strange Situation when infants were 14 months old and mothers reported on infants' behavior problems when infants were 27 months old. Mothers who reported greater emotion regulation difficulties were more physiologically dysregulated during stressful parenting tasks and also showed lower levels of maternal sensitivity at 6 months. Mother-reported dysregulation predicted higher likelihood of infant attachment disorganization and more behavior problems. Results suggest that the DERS is a valid measure of maternal emotional dysregulation and may be a useful tool for future research and intervention efforts aimed toward promoting positive parenting and early child adjustment.En el presente estudio, evaluamos el punto al cual la madre reporta la desregulación de la emoción en el Cuestionario de Dificultades con la Regulación de la Emoción (DERS) (1) presentaba una convergencia con índices fisiológicos de desregulación de la emoción durante la crianza, (2) se correlacionaba con la sensibilidad materna, y (3) predecía la desorganización de la afectividad del infante y problemas de comportamiento en un grupo muestra de 259 madres y sus infantes. Cuando los infantes tenían 6 meses de edad, se midió la excitación y regulación fisiológica de las madres durante tareas de crianza y las madres completaron el DERS. La sensibilidad de las madres fue observada durante una tarea que motivaba la angustia cuando los infantes tenían 6 y 14 meses de edad. La desorganización de la afectividad del infante fue evaluada durante una sesión de la Situación Extraña cuando los infantes tenían 14 meses de edad y las madres reportaron acerca de los problemas de comportamiento de los infantes cuando los infantes tenían 27 meses de edad. Las madres que reportaron mayores dificultades con la regulación de la emoción se encontraban más desreguladas fisiológicamente durante las estresantes tareas de crianza y también mostraron más bajos niveles de sensibilidad materna a los 6 meses. La desregulación reportada por las madres predijo una más alta propensión de la desorganización de afectividad del infante y más problemas de comportamiento. Los resultados sugieren que el DERS es una medida válida para la desregulación emocional materna y pudiera ser una herramienta útil para la futura investigación y los esfuerzos de intervención con miras a promover la crianza positiva y la adaptación temprana del niño. Palabras claves: regulación de la emoción, interacción madre-infante, desorganización de la afectividad, problemas de comportamiento, regulación fisiológica.Dans cette étude nous avons évalué dans quelle mesure la dysrégulation de l’émotion rapportée par la mère dans le Questionnaire sur les Difficultés de Régulation de l'Emotion (DERS, soit en anglais Difficulties with Emotion Regulation Questionnaire) (1) convergeait avec des indices physiologiques de dysrégulation de l’émotion durant le parentage, (2) était liée à la sensibilité maternelle, et (3) prédisait la désorganisation de l'attachement du nourrisson et des problèmes de comportement chez un échantillon de 259 mères et leurs bébés. Lorsque les bébés ont atteint l’âge de soi moi, la stimulation physiologique des mères et la régulation ont été mesurées durant des exercices de parentage et les mères ont rempli le questionnaire DERS. La sensibilité maternelle a été observée durant les exercices déclenchant de la détresse quand les bébés avaient 6 et 14 mois. La désorganisation de l'attachement du bébé a été évaluée en utilisant la Situation Etrange lorsque les bébés avaient 14 mois et les mères ont fait état des problèmes de comportement de leurs bébés lorsque ceux-ci avaient 27 mois. Les mères ayant rapporté de plus grandes difficultés de régulation de l’émotion étaient plus dysrégulées physiologiquement durant les exercices de parentage stressant et faisaient également preuve de niveaux de sensibilité maternelle plus bas à six mois. La dysrégulation rapportée par la mère prédisait une plus grande propension à la désorganisation de l'attachement du bébé et plus de problèmes de comportement. Les résultats suggèrent que le questionnaire DERS est une mesure valide de la dysrégulation émotionnelle maternelle et peut être un outil utile pour les recherches à venir et les efforts d'intervention visant la promotion d'un parentage positive et l'ajustement précoce de l'enfant. Mots clés: régulation de l’émotion, interaction mère-bébé, désorganisation de l'attachement, problèmes de comportement, régulation physiologique.Die selbsteingeschätzte Emotionsdysregulation von Müttern: Eine potenziell valide Methode im Bereich der psychischen Gesundheit von Kleinkindern In der vorliegenden Studie untersuchten wir an einer Stichprobe von 259 Müttern und ihren Kleinkindern, inwiefern selbstberichtete mütterliche Emotionsdysregulation (1) mit physiologischen Anzeichen einer Emotionsdysregulation übereinstimmt, (2) mit mütterlicher Sensitivität korreliert und (3) desorganisierte Bindung und Verhaltensprobleme beim Kleinkind vorhergesagt. Die Emotionsdysregulation der Mütter wurde durch den Fragebogen zu Schwierigkeiten in der Emotionsregulation (Difficulties with Emotion Regulation Questionnaire; DERS) erhoben. Als die Kinder 6 Monate alt waren, wurde bei den Müttern physiologische Erregung und Regulierung gemessen während sie sich um den Säugling kümmerten, außerdem füllten die Mütter den DERS aus. Die Sensitivität der Mütter wurde erhoben, indem sie bei stresshervorrufenden Aufgaben beobachtet wurden als die Kinder 6 und 14 Monate alt waren. Desorganisierte Bindung wurde im Alter von 14 Monaten mithilfe des „fremde Situation“ Paradigmas beurteilt. Verhaltensprobleme der Kinder wurden durch einen Bericht der Mütter erhoben, als die Kinder 27 Monate alt waren. Mütter, die von größeren Schwierigkeiten bei der Emotionsregulation berichteten, waren während den stresshervorrufenden Aufgaben auch physiologisch stärker dysreguliert und zeigten nach 6 Monaten eine geringere mütterliche Sensitivität. Die von den Müttern berichtete emotionale Dysregulation sagte eine höhere Wahrscheinlichkeit von desorganisierten Bindungsstilen und mehr Verhaltensprobleme voraus. Die Ergebnisse legen nahe, dass der DERS ein valides Maß für mütterliche Emotionsdysregulation ist und ein nützliches Instrument für zukünftige Forschungs- und Interventionsbemühungen sein könnte, die auf die Förderung positiver Elternkompetenz und frühkindlicher Anpassung abzielen. Schlüsselwörter: Emotionsregulation, Mutter-Kind-Interaktion, desorganisierter Bindungsstil, Verhaltensprobleme, physiologische Regulation.本研究において、我々は、259組の乳幼児母子対象者に対し、感情制御困難性尺 度(DERS)において母親自身が報告する感情調節不全が (１) 育児中の感情調節不 全の生理学的指標に収束する (２) 母親の感受性と相関がある (３) 乳幼児の混 乱型アタッチメントと行動問題を予測する、そのそれぞれの程度について評定し た。乳幼児が生後6ヶ月の時、育児の最中の母親の生理学的覚醒と調節を測定し、 また母親はDERSを全て記入した。乳幼児が生後6ヶ月時と14ヶ月時、ストレス誘 発をするタスク中に、 母親の感受性を観察した。乳幼児が生後14ヶ月時にスト レインジ・シチュエーションによって、乳幼児の混乱型アタッチメントを評価し、 生後27ヶ月時に、母親が乳幼児の行動問題について報告をした。より大きな感 情調節の困難さを報告した母親は、ストレスの多い育児の最中に、より生理学的 に調節不全であり、産後6ヶ月時においては母親の感受性がより低いことを示し ていた。母親が報告した調節不全が、乳幼児の混乱型アタッチメントのより高い 可能性と、より多くの行動問題を予測した。 結果は、DERSは母親の感情調節不 全を測定するのに有効な方法であり、今後の研究や、ポジティブな育児や乳幼児 の適応の促進を目的とした介入に有用なツールとなるであろうことを示唆してい る。 キーワード: 感情調節、母子相互交流、混乱型アタッチメント、行動問題、生理 学的調節.在本研究中, 我们对259组母婴样本使用情绪调节困难问卷 (DERS) 评估了母亲报告的情绪失调的程度:(1) 与育儿时情绪失调的生理指标一致, (2) 与母亲敏感性相关, (3) 预测了婴儿的依恋混乱和行为问题。当婴儿6个月大时, 在育儿任务中测量了母亲的生理唤醒和调节能力, 并且母亲完成了情绪调节困难问卷 (DERS) 。当婴儿6个月和14个月大时, 在诱发痛苦任务中观察了母亲敏感性。当婴儿14个月大时, 评估了婴儿在陌生情境中的依恋混乱;当婴儿27个月大时, 母亲报告了婴儿的行为问题。情绪失调程度更大的母亲在紧张的育儿任务中更容易出现生理失调, 并且在婴儿6个月时表现出较低的母亲敏感性。母亲报告的失调预示着婴儿依恋混乱的可能性更高, 行为问题也更多。研究结果表明, DERS是一种测量母亲情绪失调的有效方法, 并有可能成为未来研究、促进积极的育儿能力和早期儿童适应能力的有效工具。 关键词: 情绪调节, 母婴互动, 依恋混乱, 行为问题, 生理调节.أعراض اكتئاب الأم قبل الولادة وما بعد الولادة ومشاكل نوم الرضيع في ستة أشهر ارتبط اكتئاب الأم قبل الولادة وبعد الولادة بمشاكل نوم الرضع. هدفت هذه الدراسة إلى تحليل (1) آثار أعراض اكتئاب الأم قبل الولادة وبعد الولادة، بما في ذلك آثار القلق قبل الولادة وبعد الولادة ودرجات الاكتئاب في مقياس الاكتئاب بعد الولادة في أدنبرة(EPDS) ، على مشاكل نوم الرضع في ستة أشهر، و(2) تأثير التفاعل بين أعراض اكتئاب الأم قبل الولادة وبعد الولادة وجنس الرضيع على مشاكل النوم في ستة أشهر. وكانت العينة تتألف من 164 من ثنائيات الأم والرضيع التي أكملت أمهاتها مقاييس الاكتئاب في الثلث الثالث من الحمل، وأسبوعين وثلاثة وستة أشهر بعد الولادة، ومقياس لمشاكل نوم الرضع في ستة أشهرI). -(CSHQ أعراض الاكتئاب قبل الولادة عند الأم، وتحديدا درجات الاكتئاب منEPDS ، تنبأت بالمزيد من قلق النوم عند الرضع ونعاس النهار، في حين أن أعراض الاكتئاب عند الأم في أسبوعين بعد الولادة، وتحديدا درجات القلق من EPDS، تنبأت بالمزيد من مقاومة وقت النوم وI -CSHQمجموع درجات مقياس مشاكل النوم I-CSHQ عند ستة أشهر. أظهر الأولاد من الأمهات الذين لديهم أعراض الاكتئاب قبل الولادة مزيدا من اقلق النوم عند ستة أشهر. كل من أعراض اكتئاب الأم قبل الولادة والمبكرة بعد الولادة لها تأثير سلبي على ظهور مشاكل نوم الرضيع. بالإضافة إلى ذلك، يبدو أن الأولاد أكثر عرضة لأعراض اكتئاب الأم قبل الولادة. الكلمات الرئيسية: اكتئاب ما قبل الولادة، اكتئاب ما بعد الولادة، مشاكل النوم، النمو، الاختلافات بين الجنسين.

The present study examined the degree to which toddlers’ affect during the Parent Ignore Toddler Situation (PITS), a modified still-face paradigm, with mothers and fathers was predicted by attachment, temperamental negative reactivity, and attachment X negative reactivity during infancy. Parents (N = 135) were predominantly Caucasian (90.3% of mothers and 87.4% of fathers) and rated their infants’ temperament using the Infant Behavior Questionnaire when infants were 3, 5, 7, 12, and 14 months; attachment to mothers and fathers was assessed from the Strange Situation when infants were 12 and 14 months of age. Toddler positive and negative affect were rated from each episode of the PITS, separately with mothers and fathers, when toddlers were 20-months. Results from multi-level models, controlling for baseline affect and current parent sensitivity, indicated several effects involving attachment, but not temperament. An Episode X Avoidant attachment interaction indicated that toddlers who were classified as avoidant with either parent during infancy showed a flattened pattern of positive affect across the PITS episodes compared with those classified as secure. In contrast, a Parent X Ambivalent attachment interaction indicated that toddler negative affect was higher when they had an ambivalent attachment with mothers but not fathers.

The purpose of this study is to clarify the magnitude of the association between maternal depression and infant attachment nonsecurity, and to identify possible moderators of this relationship. An extensive literature search was conducted using multiple databases of both published and unpublished studies. A meta-analysis was conducted to determine the relationship between maternal depression and infant attachment security and to establish the effect size. The main findings from this meta-analysis, which included 42 studies, indicate that there is a small, yet significant, relationship between maternal depression and infant attachment nonsecurity. The rate of nonsecurity in infants of mothers with depression was approximately 20% higher than expected rates in a nonclinical population, and the association between depressive symptoms and nonsecurity was small, but significant. Infants of mothers with depression were nearly twice as likely to have a nonsecure attachment than were infants of healthy mothers. Depression measure and maternal sample source were identified as significant moderators of the odds ratio effect size. Results of this study demonstrate that there is a significant relationship between maternal depression and infant attachment nonsecurity, and suggest that interventions that focus on both maternal mental health and the attachment relationship are warranted.Propósito: Clarificar la magnitud de las asociaciones entre la depresión materna y la falta de seguridad en la afectividad del infante, así como identificar posibles moderadores de esta relación. Métodos: Se llevó a cabo una extensa búsqueda de la literatura existente usando múltiples bancos de información tanto de estudios publicados como de los no publicados. Se realizó un meta-análisis para determinar la relación entre la depresión materna y la seguridad de la afectividad del infante y establecer la dimensión del efecto. Resultados: Los principales resultados de este meta-análisis, el cual incluyó 42 estudios, indicaron que existe una pequeña pero significativa relación entre la depresión materna y la falta de seguridad en la afectividad del infante. La tasa de falta de seguridad en infantes de madres con depresión fue aproximadamente 20% más alta que la tasa esperada en una población no clínica, y la asociación entre los síntomas depresivos y la falta de seguridad fue pequeña pero significativa. Los infantes de madres con depresión estuvieron casi dos veces más propensos a tener una afectividad no segura que los infantes de madres saludables. Se identificó la medida de depresión y la fuente del grupo muestra materno como moderadores significativos de la dimensión del efecto en las posibilidades promedio. Conclusiones: Los resultados de este estudio demuestran que existe una significativa relación entre la depresión materna y la falta de seguridad en la afectividad del infante, y sugieren que las intervenciones que se enfocan tanto en la salud mental materna como en la relación de afectividad están garantizadas.But: Clarifier la magnitude du lien entre la dépression maternelle et l'insécurité de l'attachement du nourrisson, et identifier des facteurs de modération possibles de cette relation. Méthodes: Une importante recherche sur les recherches a été faite en utilisant plusieurs bases de données comprenant à la fois des études publiées et des études non publiées. Une méta-analyse a été faite afin de déterminer la relation entre la dépression maternelle et la sécurité de l'attachement du nourrisson et afin d’établir la taille de l'effet. Résultats: Les principaux résultats de cette méta-analyse, qui a porté sur 42 études, ont indiqué qu'il existe une relation petite et cependant importante entre la dépression maternelle et l'insécurité de l'attachement du nourrisson. Le taux d'insécurité chez les nourrissons de mère avec une dépression était lié à des taux environ 20% plus élevés que les taux attendus chez une population non-clinique, et le lien entre les symptômes dépressifs et la non-sécurité était limité mais important. Les nourrissons de mères avec une dépression étaient presque deux fois plus à même d'avoir un attachement insécure que les nourrissons de mères en bonne santé. La mesure de dépression et la source de l’échantillon maternel ont été identifiées comme étant des facteurs de modération importants de l'ampleur des effets des rapports de cote. Conclusions: Les résultats de cette étude démontrent qu'il existe une relation importante entre la dépression maternelle et l'insécurité de l'attachement du nourrisson, et suggèrent que les interventions qui mettent l'accent à la fois sur la santé mentale maternelle et la relation d'attachement sont justifiées.Mütterliche Depression und kindliche Bindungssicherheit: Eine Meta-Analyse Ziel: Ziel der vorliegenden Studie war es, das Ausmaß des Zusammenhangs zwischen mütterlicher Depression und kindlicher Bindungsunsicherheit zu prüfen, sowie mögliche Moderationsvariablen zu identifizieren. Methoden: Eine umfangreiche Literaturrecherche anhand mehrerer Datenbanken sowohl veröffentlichter als auch unveröffentlichter Studien wurde durchgeführt. Mithilfe einer Meta-Analyse wurden der Zusammenhang zwischen mütterlicher Depression und kindlicher Bindungssicherheit geprüft und entsprechende Effektstärken berechnet. Ergebnisse: Die Hauptergebnisse der 42 Studien einschließenden Meta-Analyse deuten darauf hin, dass es zwischen mütterlicher Depression und kindlicher Bindungsunsicherheit einen zwar kleinen jedoch signifikanten Zusammenhang gibt. Bei den Müttern mit Depression war der Anteil unsicher gebundener Kinder ca. 20% höher als man es in einer nicht-klinischen Stichprobe erwarten würde. Die Wahrscheinlichkeit einer unsicheren Bindung war bei Kindern depressiver Mütter doppelt so hoch wie bei Kindern gesunder Mütter. Sowohl das Depressionsmaß als auch die Quelle der mütterlichen Stichprobe wurden als signifikante Moderatorvariablen der Odds-Ratio Effektstärken ermittelt. Fazit: Die Ergebnisse dieser Studie zeigen, dass es einen signifikanten Zusammenhang zwischen mütterlicher Depression und kindlicher Bindungsunsicherheit gibt. Außerdem bestätigen sie die Berechtigung von Interventionen, die sowohl auf die psychische Gesundheit der Mutter als auch Mutter-Kind Bindung abzielen.母親の抑うつと乳幼児の愛着安定性:メタ解析 目的: 母親の抑うつと乳幼児の愛着不安定性の関連性を明らかにし、関係性を仲介し得るものを特定すること。 方法: 発表された研究、未発表の研究両方を複数のデータベースを用い、広範囲な文献検索を行った。母親の抑うつと乳幼児の愛着安定性の関係性を測定し、その効果量を定めるために、メタ解析を行った。 結果: 42 件の研究を含むこのメタ解析の主要結果は、母親の抑うつと乳幼児の愛着不安定性の間に小さいが有意な関係性があると示した。抑うつ症状のある母親への愛着不安定性をもつ乳幼児の割合は、医療にかからない人口に予想されるよりも約 20%高く、抑うつ症状と不安定性の関連性は小さいが有意であった。抑うつ症状のある母親の乳幼児は、健康的な母親の乳幼児より2倍近く不安定型愛着を示した。抑うつの尺度 と母親のサンプル元は、効果量のオッズ比を有意な調整変数として同定された。 結論: この研究結果は、母親の抑うつと乳幼児の愛着の不安定さには有意な関係性があることを示し、母親のメンタルヘルスと愛着関係性の両方に焦点を当てた介入が正当であることを示唆する。.母親抑鬱症和嬰兒依附安全:整合分析 目的: 澄清母親抑鬱與非安全嬰兒依附之關聯， 並確定這種關係的調節變數。 方法: 使用已發表和未發表的研究的多個數據庫， 進行廣泛的文獻檢索。以整合分析， 確定母親抑鬱與嬰兒依附安全的關係， 並確定其效應值。 結果: 整合分析包括42項研究， 發現母親抑鬱與嬰兒非安全依附之間存在一個小但顯著的關係。抑鬱症母親的嬰兒非安全依附比非臨床人群的預期率高約 20％， 抑鬱症狀與非安全依附的關聯小但顯著。抑鬱症母親的嬰兒患有非安全依附的可能性幾乎是健康母親的嬰兒的兩倍。抑鬱測量工具和母體樣本來源被確定為勝算比效應大小的重要調節變數。 結論: 這項研究的結果表明， 母親抑鬱與嬰兒非安全依附之間存在顯著關係， 並表明有必要關注母親心理健康和依附關係的干預措施。.الاكتئاب الأمومي وأمان التعلق لدى الرضع: تحليل تلوي الغرض من الدراسة: توضيح حجم العلاقة بين الاكتئاب الأمومي وعدم أمن تعلق الرضع، وتحديد المتغيرات الوسيطة المحتملة لهذه العلاقة. طريقة البحث: تم إجراء بحث مستفيض في الأدبيات السابقة باستخدام قواعد بيانات متعددة للدراسات المنشورة وغير المنشورة على السواء. وأُجري تحليل تلوي لتحديد العلاقة بين اكتئاب الأمهات وأمن التعلق لدى الرضع وتحديد حجم التأثير. النتائج: أشارت النتائج الرئيسية لهذا التحليل التلوي، الذي شمل 42 دراسة، إلى وجود علاقة صغيرة ولكنها دالة إحصائيا بين اكتئاب الأمهات وعدم أمن تعلق الرضع. وكان معدل عدم الأمن لدى الرضع من الأمهات المصابات بالاكتئاب أعلى بنسبة 20 في المائة تقريباً من المعدل المتوقع في عموم الناس في سياق غير إكلينيكي، وكان الارتباط بين أعراض الاكتئاب وعدم الأمن صغيراً ولكنه دال إحصائيا. وكان احتمال تعرض أطفال الأمهات المصابات بالاكتئاب بتعلق غير آمن ضعف احتمال تعرض أطفال الأمهات الأصحاء للتعلق غير الآمن. وتم تحديد مقياس الاكتئاب ومصدر عينة الأمومة كمتغيرات وسيطة هامة لحجم تأثير نسبة الاحتمالات. الاستنتاجات: تظهر نتائج هذه الدراسة أن هناك علاقة هامة بين الاكتئاب الأمومي وتعلق الرضع غير الأمن، وتشير إلى أهمية إجراء التدخلات التي تركز على كل من الصحة النفسية للأمهات وعلاقة التعلق.

Objective: \ud The objective of this study was to investigate whether bed-sharing during the first 6 months of life is associated with infant's attachment and behavioral outcomes and mother's bonding and sensitive parenting at 18 months of age.\ud \ud Methods: \ud The sample with complete longitudinal data comprised 178 infants and their caretakers. Bed-sharing was assessed with maternal report at term, 3, 6, and 18 months. Infant attachment was measured at 18 months using the strange situation procedure. Infant behavioral outcomes (i.e., poor attention/hyperactivity and task persistence) were assessed with 2 observational measures at 18 months. Maternal sensitivity was observed at 3 and 18 months, and mothers reported on bonding to their infant at term, 3, and 18 months.\ud \ud Results: \ud Bed-sharing was common at term (41.2%), which decreased at 3 months (22.6%) followed by a slight increase at 6 (27.5%) and 18 months of age (31.3%). No associations between bed-sharing during the first 6 months and infant-mother attachment and infant behavioral outcomes at 18 months were found. Similarly, there were no associations between bed-sharing during the first 6 months and maternal bonding and sensitivity at consequent assessment points (i.e., 3 and 18 months).\ud \ud Conclusion: \ud Bed-sharing during the first 6 months is not associated with positive or negative outcomes about infant-mother attachment, infant behavior, maternal bonding, or sensitive parenting.

Maternal (Klaus, Kennell & Klaus, 1996) bonding during pregnancy is associated with positive infant attachment, whereas unresolved, dissociated trauma, chronic affect dysregulation, and obstetric c...

In this article, we describe the results of the second phase of a randomized controlled trial of Minding the Baby (MTB), an interdisciplinary reflective parenting intervention for infants and their families. Young first-time mothers living in underserved, poor, urban communities received intensive home visiting services from a nurse and social worker team for 27 months, from pregnancy to the child's second birthday. Results indicate that MTB mothers' levels of reflective functioning was more likely to increase over the course of the intervention than were those of control group mothers. Likewise, infants in the MTB group were significantly more likely to be securely attached, and significantly less likely to be disorganized, than infants in the control group. We discuss our findings in terms of their contribution to understanding the impacts and import of intensive intervention with vulnerable families during the earliest stages of parenthood in preventing the intergenerational transmission of disrupted relationships and insecure attachment.

Two antecedents of the insightfulness of adolescents into a close friend's experience were examined: The insightfulness of the mother and the attachment of the child, both measured when the adolescent was an infant. We hypothesized that both antecedents would be associated with adolescent insightfulness. Maternal insightfulness was assessed using the Insightfulness Assessment (IA) in which mothers are interviewed about their children's thoughts and feelings after viewing short video segments of their interactions with their children, and infant attachment was assessed using the Strange Situation Procedure. Adolescent insightfulness was assessed using an adaptation of the IA in which the adolescents were interviewed about their friend's thoughts and feelings after viewing short video segments of their interactions with them. As predicted, the results showed that adolescents were more likely to show insightfulness toward their friend when their mothers had been insightful toward them when they were infants and when they had secure attachment with their mothers. When both predictors were considered together, maternal insightfulness remained predictive of adolescent insightfulness but infant attachment was no longer significant.

Research on attachment transmission has focused on variable-centered analyses, where hypotheses are tested by examining linear associations between variables. The purpose of this study was to apply a relationship-centered approach to data analysis, where adult states of mind, maternal sensitivity, and infant attachment were conceived as being three components of a single, intergenerational relationship. These variables were assessed in 90 adolescent and 99 adult mother–infant dyads when infants were 12 months old. Initial variable-centered analyses replicated the frequently observed associations between these three core attachment variables. Relationship-based, latent class analyses then revealed that the most common pattern among young mother dyads featured maternal unresolved trauma, insensitive interactive behavior, and disorganized infant attachment (61%), whereas the most prevalent adult mother dyad relationship pattern involved maternal autonomy, sensitive maternal behavior, and secure infant attachment (59%). Three less prevalent relationship patterns were also observed. Moderation analyses revealed that the adolescent–adult mother distinction differentiated between secure and disorganized intergenerational relationship patterns, whereas experience of traumatic events distinguished between disorganized and avoidant patterns. Finally, socioeconomic status distinguished between avoidant and secure patterns. Results emphasize the value of a relationship-based approach, adding an angle of understanding to the study of attachment transmission.

Resulting from a community-identified need for a well-validated indicator of caregiving difficulties for use in practice settings, a brief form of the Atypical Maternal Behavior Instrument for Assessment and Classification System (AMBIANCE) was developed for use as a screening instrument. Prior to its dissemination, this study aimed to assess the feasibility, reliability, and validity of the AMBIANCE-Brief. Adolescent mother-infant dyads (N = 69) participated in the Strange Situation Procedure, as well as play sessions with and without toys. Maternal disrupted caregiving was coded from the play sessions using the AMBIANCE and AMBIANCE-Brief. The AMBIANCE-Brief demonstrated convergent validity with the AMBIANCE in the play session with toys (r = .65, p .001) and without toys (r = .61, p .001). Concurrent validity of the AMBIANCE-Brief was also demonstrated in relation to infant attachment disorganization in the play session with toys (r = .36, p .05) and without toys (r = .32, p .01). These findings suggest a shorter protocol for assessing disrupted caregiving may be feasible and valid for use in community settings. Future studies are in progress to train community practitioners in the use of the AMBIANCE-Brief and to evaluate their reliability.Como resultado de una necesidad identificada por la comunidad para un indicador bien validado de dificultades en la prestación de cuidado para uso en escenarios prácticos, se desarrolló una forma breve del Sistema del Instrumento de Conducta Materna Atípica para la Evaluación y Clasificación (AMBIANCE) para ser usado como instrumento de detección. Antes de ser diseminado, la meta de este estudio fue de evaluar la posibilidad, confiabilidad y validez de AMBIANCE-Abreviado. Las díadas de madres adolescentes e infantes (N = 69) participaron en el Procedimiento de la Situación Extraña, así como en sesiones de juego con y sin juguetes. La interrumpida prestación de cuidado materna fue codificada a partir de las sesiones de juego usando AMBIANCE y AMBIANCE-Abreviado. El AMBIANCE-Abreviado demostró una validez convergente con AMBIANCE en la sesión de juego con juguetes (r = .65, p.001) y sin juguetes (r = .61, p.001). También se demostró la validez concurrente de AMBIANCE-Abreviado en relación con la desorganización de la afectividad del infante en la sesión de juegos con juguetes (r = .36, p.05) y sin juguetes (r = .32, p.01). Estos resultados sugieren que un protocolo más corto para evaluar la interrumpida prestación de cuidado pudiera ser posible y válido para uso en escenarios comunitarios. Hay estudios futuros en progreso para entrenar al personal de la práctica comunitaria en el uso de AMBIANCE-Abreviado y para evaluar su confiabilidad.Résultat d'un besoin identifié au niveau communautaire d'un indicateur bien validé de difficultés dans les soins pour une utilisation dans des contextes de pratique, une forme écourtée (“brève”, ci-dessous) de l'Instrument d'Evaluation et du Système de Classification du Comportement Maternel Atypique (abrégé AMBIANCE en anglais, nous gardons ici l'abréviation anglaise) a été développée pour une utilisation à des fins d'outil de dépistage. Avant sa dissémination, cette étude s’était donnée pour but d’évaluer la faisabilité, la fiabilité et la validité de l'AMBIANCE-Brève. Des dyades adolescentes mères-nourrissons (N = 69) ont participé à la Procédure de Situation Etrange, ainsi qu’à des séances de jeu avec et sans jouets. Les soins maternels perturbés ont été codés à partir des séances de jeu en utilisant l'AMBIANCE et l'AMBIANCE-Brève. L'AMBIENCE-Brève a fait preuve de validité de convergence avec l'AMBIENCE dans les séances de jeu avec des jouets (r = ,65, p ,001) et sans jouets (r = ,61, p,001). La validité concurrente de l'AMBIENCE-Brève a aussi été démontrée pour ce qui concerne la désorganisation de l'attachement du bébé dans la séance avec les jouets (r = ,36, p ,05) et sans jouets (r = ,32, p ,01). Ces résultats suggèrent qu'un protocole écourté pour l’évaluation de soin perturbé peut s'avérer plus fiable et valide pour l'utilisation en contexte communautaire. Des études supplémentaires sont en cours afin de former les praticiens communautaires à l'utilisation de l'AMBIENCE-Brève et afin d’évaluer leur fiabilité.Eine Validierung des AMBIANCE-Brief: Ein Beobachtungs-Screening-Instrument für gestörte Kinderbetreuung Aufgrund des von der Forschungsgemeinde ermittelten Bedarfs an einem gut validierten Indikator für gestörtes Betreuungsverhalten im Praxissetting wurde eine Kurzform des Screening-Instruments „Beurteilungs- und Klassifikationssystem für atypisches mütterlichen Verhalten“ (Atypical Maternal Behavior Instrument for Assessment and Classification System; AMBIANCE) entwickelt. Ziel der vorliegenden Studie war es, vor der Veröffentlichung die Durchführbarkeit, Reliabilität und Validität des AMBIANCE-Briefs zu beurteilen. N = 69 adoleszente Mutter-Kind-Dyaden nahmen am Fremde-Situationsparadigma und an Spielsitzungen mit und ohne Spielzeug teil. Mütterliches gestörtes Betreuungsverhalten wurde in den Spielsitzungen mithilfe des AMBIANCE und des AMBIANCE-Brief codiert. Das AMBIANCE-Brief zeigte gegenüber dem AMBIANCE im Spiel mit Spielzeug (r = .65, p.001) und ohne Spielzeug (r = .61, p.001) konvergente Validität. Die übereinstimmende Validität des AMBIANCE-Briefs konnte außerdem in Bezug auf desorganisierte Bindung in der Spielsitzung mit Spielzeug (r = .36, p.05) und ohne Spielzeug (r = .32, p.01) nachgewiesen werden. Diese Ergebnisse legen nahe, dass ein kürzeres Verfahren zur Beurteilung von gestörtem Betreuungsverhalten durchführbar und für die Verwendung im Community-Setting valide sein könnte. Zukünftige Studien werden durchgeführt, um Community-Praktiker*innen in der Verwendung des AMBIANCE-Briefs zu schulen und ihre Reliabilität zu bewerten.簡易AMBIANCEの検証:育児困難のための観察的スクリーニング手段 実践現場で用いるための、育児困難に関して充分に検証された指標についての地域の特定された必要性を受けた結果として、非典型母親行動の査定分類検査(AMBIANCE)がスクリーニング手段として開発された。その普及に先立ち、本研究 は簡易AMBIANCEの実行可能性、信頼性、妥当性を評価することを目的とした。若 年の母親と乳児からなる親子 (N=６９) はストレンジシチュエーション、おも ちゃを用いるプレイセッション、用いないプレイセッションに参加した。母親の 育児困難はAMBIANCEと簡易ANBIANCEを用いたプレイセッションからコード化され た。簡易AMBIANCEは、おもちゃを用いたプレイセッション(r = .65, p.001) と用いないプレイセッション(r = .61, p.001)においてAMBIANCEと共に収束 的妥当性を示した。簡易AMBIANCEは、おもちゃを用いたプレイセッション(r = .36, p.05)と、用いないプレイセッション (r=.32, p.01) における乳児の愛着混乱に関しても併存的妥当性を示した。これらの結果は、育児困難を評価するためのより簡潔なプロトコールが地域現場において用いるために実行可能であり有効であることを示す。簡易 AMBIANCEの利用において地域実践者を訓練し、その信頼性を評価する為にさらなる研究が進行中である。.由于社区医疗机构对经过充分验证的看护困难指标的实际需求, 因此开发了一种简便类型的“非典型母亲行为评定分类系统”(AMBIANCE) 用作筛查工具。在发布之前, 本研究旨在评估简要AMBIANCE的可行性、可靠性和有效性。未成年的母婴二人组 (N = 69) 参与了 “陌生情境程序”测验, 以及有玩具和无玩具的游戏。在游戏中利用AMBIANCE和简要AMBIANCE编码了母亲的中断看护。在有玩具 (r = .65, p.001) 和无玩具 (r = .61, p.001) 的游戏中, 简要AMBIANCE表现出与AMBIANCE的聚合效度。在有玩具 (r = .36, p.05) 和无玩具 (r = .32, p.01) 的游戏中, 简要AMBIANCE也表现出与婴儿依恋絮乱的共时效度。这些发现表明, 在社区医疗机构中使用一个较短的评估中断看护的方案可能是可行和有效的。未来的研究正在进行中, 以培训社区从业人员使用简要AMBIANCE, 并评估其可靠性。.التحقق من أداة قياس (AMBIANCE) المختصرة: أداة فحص لرصد وملاحظة الرعاية المتقطعة في ضوء حاجة المجتمعات المحلية لوضع مؤشر محقق لصعوبات الرعاية لاستخدامها في الممارسات العملية ، تم وضع نموذج مختصر لأداه السلوك الأمومي الغير نمطي لنظام التقييم والتصنيف (AMBIANCE) لاستخدامها كأداه للفحص. وكانت هذه الدراسة ، قبل نشرها ، تهدف إلى تقييم الجدوى والموثوقيه والصلاحية لهذا المقياس. شارك في الدراسة ثنائيات من الأمهات المراهقات و الرضع (N = 69) من خلال “إجراء الموقف الغريب” ، بالإضافة إلى جلسات اللعب مع ألعاب أو بدون ألعاب. وقد تم ترميز رعاية الأمهات المضطربة من جلسات اللعب باستخدام مقياس AMBIANCE الشامل والمختصر. أظهر المقياس المختصر صحة متقاربة مع المقياس الشامل في جلسة اللعب باستخدام الألعاب (r = 65 ، p.001) وبدون ألعاب (r = .61, p.001). وكانت الصلاحية المتزامنة للمقياس المختصر الأجواء واضحة فيما يتعلق بعدم تنظيم تعلق الرضع في جلسة اللعب باستخدام الألعاب (r = 36 ، p.05) وبدون ألعاب (r = .32, p.01). وتوحي هذه النتائج بان وضع بروتوكول أقصر لتقييم الرعاية المضطربة قد يكون ممكنا وصالحا للاستخدام في الأوساط المجتمعية. وتجري الدراسات المستقبلية لتدريب الممارسين المجتمعيين علي استخدام المقياس المختصر وتقييم موثوقيته.

Background Intimate Partner Violence (IPV) is associated with increased risk of impairment to a child’s emotional, behavioural, and psychological functioning. Further, the presence of IPV is negatively associated with a child’s attachment to their primary caregivers, which is an additional risk factor for social, emotional, and psychological impairment. Objective The aim of this systematic review and meta-analysis was to synthesise the evidence on the association between IPV and the attachment of infants, children, and adolescents to their primary caregiver/s. Method A systematic review was completed, in accordance with the PRISMA statement, on IPV and the parent-child attachment of infants, children, and adolescents (18 years and younger). Meta-analyses were conducted to estimate the magnitude of these associations. Results A total of 15 studies were included. IPV was significantly associated with less secure child attachment. The pooled effect sizes (Pearson’s r) for both longitudinal studies (n = 5) and cross-sectional and retrospective studies combined (n = 10) were small (r = −.22, 95 % CI [−.32, −.12], p < .001; r = −.10, 95 % CI [−.203, −.001], p = .048). Subgroup analyses identified that the effect size was larger when IPV and attachment were measured during infancy compared to childhood, and when attachment was measured via observational methods compared to self-report. Conclusion While the current literature base is limited, findings can inform further research alongside clinical assessment and intervention. It can also help guide attachment- and family-based intervention for families impacted by IPV.

Postpartum depression is related to inadequately sensitive caregiving, putting infants at risk for insecure attachment. Therefore, promoting sensitive maternal caregiving and secure child attachment is particularly important in postpartum depressed mothers and their infants. In this randomized-controlled-trial, we evaluated the efficacy of the Circle of Security-Intensive (COS-I)-intervention in supporting maternal sensitivity and mother-infant-attachment compared to treatment-as-usual (TAU) with unresolved-maternal attachment as a moderator of treatment effect. Eligible mothers with infants (N=72) 4-9 months-old were randomly assigned to treatment (n=36 dyads). Infant attachment was rated at follow-up (child age 16-18 months) (Strange-Situation-procedure). Maternal sensitivity was measured at baseline and follow-up (Mini-Maternal-Behavior-Q-sort). Maternal-unresolved-attachment was assessed at baseline (Adult-Attachment-Interview). We found no significant differences between treatments in infant attachment nor changes in mothers’ sensitivity. However, in COS-I, unresolved-mothers exhibited significantly more change in sensitivity than non-unresolved-mothers, whereas in TAU, the opposite was true. These findings may help to optimize clinical use of COS-I.

Zusammenfassung. Fragestellung: Untersuchung der Bedeutung von mütterlicher Sozialer Phobie für die Entwicklung der Mutter-Kind-Beziehung in einer prospektiv-longitudinalen Studie. Methodik: Eine Teilstichprobe von 46 Frauen mit vs. ohne Lebenszeitdiagnose einer Sozialen Phobie und deren Kindern wurde analysiert. Soziale Phobien der Mütter wurden mit dem Composite International Diagnostic Interview für Frauen (CIDI-V) erhoben. Die Mütter wurden zum ante- und postnatalen Bonding befragt (MAAS, MPAS) und die Kinder wurden 16 Monate nach der Geburt mit dem Fremde-Situations-Test beobachtet. Ergebnisse: Kinder von sozialphobischen Müttern waren in der Verhaltensbeobachtung prozentual häufiger unsicher gebunden (45.4 % vs. 33.3 %) und brauchten signifikant länger, um den Kontakt zur Mutter in der Wiedervereinigungsphase wiederherzustellen (U = 160.0, p = .019). In Bezug auf das ante- (t = -.151, p = .881) und postnatale (t = .408, p = .685) Bonding der Mutter an das Kind sowie im widerstehenden (U = 262.5, p = .969), vermeidenden (U = 311.5, p = .258) und kontakterhaltenden (U = 224.0, p = .373) Verhalten des Kindes in der Fremden Situation zeigten beide Gruppen vergleichbare Werte. Schlussfolgerungen: Möglicherweise haben Mütter mit Sozialer Phobie eine gehemmte Verhaltensdisposition weitergegeben oder ihre Kinder weniger zur sozialen Interaktion ermutigt als Mütter ohne Soziale Phobie. Wenn Kinder von sozialphobischen Müttern Interaktionsängste zeigen, sollte eine Aufklärung über verschiedene Therapiemöglichkeiten sowie über mögliche Konsequenzen des eigenen (Vermeidungs-)Verhaltens für die kindliche Entwicklung erfolgen.

The present study examined observations of parenting quality (mothers' emotional availability - EA) during infant bedtimes at 4 points across the infants' first year, assessing relations between levels and trajectories of emotional availability and infant attachment at 12 months and the role of infant temperament in moderating these associations. The sample (N = 128) was predominantly Euro-American (82.5%) and at low socioeconomic risk. Latent growth curve modeling with latent basis coefficients indicated substantial individual differences in initial levels and slopes in EA trajectories across the first year. Both levels of maternal EA and EA trajectories across the first year predicted 12-month infant attachment security. Although maternal EA tended to decrease across the first year in the full sample, EA trajectories that showed a “bounce-back” between 6 and 12 months, suggesting more successful maternal adaptation to an expanding infant developmental repertoire, predicted greater infant security at 12 months. In addition, linkages between latent EA trajectories and 12-month attachment were moderated by 3-month infant temperamental reactivity and regulation. These findings indicate that infant attachment security is sensitive to both static and dynamic aspects of parenting quality across the first year, and that infant temperament can interact with both in predicting infant attachment.

In this paper, we examine the associations between specific candidate genes (DRD2, DRD4, COMT, biallelic and tri-allelic 5HTTLPR, and OXTR) and infant attachment outcomes as main effects and in conjunction with maternal sensitivity. The sample included 200 infants (97 European American, 94 African American, and 9 bi-racial) and their mothers. Maternal sensitivity and overtly negative maternal behavior were observed when infants were 6 months and 1 year old in distress-eliciting contexts, attachment was assessed via the Strange Situation at age 1, and DNA samples were collected when children were 2 years old. Consistent with recent research in large samples (Luijk et al., 2011; Roisman et al., 2013), there was little evidence that these genes are associated with attachment security, disorganization, or distress as main effects (in additive, dominant, and homozygous models) or in conjunction with maternal sensitivity or overtly negative behavior (primarily dominance models). Furthermore, there was little evidence that associations vary as a function of race.

This research examined the child, parent, and family conditions under which attachment disorganization was related to both level and change in externalizing behavior during preschool among a community sample. Using the ordinary least squares regression, we found that attachment disorganization at 12 months significantly predicted children's externalizing behavior at 36 months and this prediction was not contingent on any other factors tested. For predicting changes in externalizing behavior from 36 to 60 months, we found a significant main effect of family cumulative risk and an interaction effect between attachment disorganization at 12 months and maternal sensitivity at 24 months. Specifically, high disorganization was related to a significant decrease in externalizing behavior from 36 to 60 months when maternal sensitivity at 24 months was high. Our main-effect findings replicated the significant effect of attachment disorganization and cumulative risk on externalizing behavior with preschool-aged children. Our interaction finding provided support for understanding the parenting conditions under which infant attachment disorganization may be related to change in externalizing behavior during preschool ages. Implications of the findings were discussed.

This study examined the longitudinal associations between fathers’ observed parenting behaviors and father-infant attachment (n = 58 father-infant dyads). Fathers were observed playing with their infants at 9 months postpartum and were assessed for stimulating behaviors (i.e., physical and/or object stimulation), as well as their sensitivity and intrusiveness. When the infants were 12 to 18 months of age, fathers and infants participated together in the Strange Situation Procedure (SSP) to assess father-infant attachment security. Logistic regression analyses revealed that higher levels of paternal stimulation at 9 months postpartum were associated with greater odds of classification as a secure father-infant dyad. Additionally, fathers’ observed intrusiveness at 9 months postpartum moderated this association; greater paternal stimulation was associated with significantly greater odds of father-infant attachment security at low and average levels of paternal intrusiveness, but not at high levels of paternal intrusiveness. This study provides new insight into the paternal behaviors that may foster secure father-infant attachment.

There is a dearth of good-quality research investigating the outcomes of psychoanalytic parent-infant psychotherapy (PIP). This randomized controlled trial investigated the outcomes of PIP for parents with mental health problems who also were experiencing high levels of social adversity and their young infants (

The relationship between infant behaviors during routine immunization, pre- and post-needle, and infant attachment was explored.A total of 130 parent-infant dyads were recruited from a larger longitudinal study and videotaped during routine immunization at 12 months and the Strange Situation Procedure (SSP) at 14 months. Six infant behaviors were coded for 1-minute pre-needle and 3-minutes post-needle. Attachment was operationalized according to the secure/avoidant/resistant/disorganized categories.As expected, none of the pre-needle behaviors predicted attachment. Proximity-seeking post-needle significantly discriminated attachment categorizations. Secure infants were more likely to seek proximity to caregivers post-needle in comparison with avoidant and disorganized infants. Proximity-seeking following immunization was positively correlated with proximity-seeking during the SSP and negatively correlated with avoidance and disorganization during the SSP.Infant proximity-seeking during immunization is associated with attachment security and parallels behaviors observed during the SSP. More research is needed to identify behavioral markers of disorganization.

Parents' representations of their infants consist of parents' subjective experiences of how they perceive their infants. They provide important information about the quality of the parent-infant relationship and are closely related to parenting behavior and infant attachment. Previous studies have shown that parents' representations emerge during pregnancy. However, little is known about prenatal (risk) factors that are related to parents' representations. In a prospective study, 308 mothers and 243 fathers were followed during pregnancy and postpartum. Prenatal risk factors were assessed with an adapted version of the Dunedin Family Services Indicator (T.G. Egan et al., ; R.C. Muir et al., ). At 26 weeks' gestation and 6 months' postpartum, parents' representations of their children were assessed with the Working Model of the Child Interview (C.H. Zeanah, D. Benoit, L. Hirshberg, M.L. Barton, & C. Regan). Results showed stability between pre- and postnatal representations, with fathers having more disengaged representations than did mothers. In addition, prenatal risk factors of parenting problems were associated with the quality of parents' prenatal (only in mothers) and postnatal representations. This study provides valuable information concerning parents at risk of developing nonbalanced representations of their children. In clinical practice, these families could be monitored more intensively and may be supported in developing a more optimal parent-infant relationship.

The prototype hypothesis suggests that attachment representations derived in infancy continue to influence subsequent relationships over the life span, including those formed with one's own children. In the current study, we test the prototype hypothesis by exploring (a) whether child-specific representations following actual experience in interaction with a specific child impacts caregiver-child attachment over and above the prenatal forecast of that representation and (b) whether maternal attachment representations exert their influence on infant attachment via the more child-specific representation of that relationship. In a longitudinal study of 84 mother-infant dyads, mothers' representations of their attachment history were obtained prenatally with the Adult Attachment Interview (AAI; M. Main, R. Goldwyn, & E. Hesse, 2002), representations of relationship with a specific child were assessed with the Working Model of the Child Interview (WMCI; C.H. Zeanah, D. Benoit, & L. Barton, 1986), collected both prenatally and again at infant age 11 months, and infant attachment was assessed in the Strange Situation Procedure (M.D.S. Ainsworth, M.C. Blehar, E. Walters, & S. Wall, 1978) when infants were 11 months of age. Consistent with the prototype hypothesis, considerable correspondence was found between mothers' AAI and WMCI classifications. A mediation analysis showed that WMCI fully accounted for the association between AAI and infant attachment. Postnatal WMCI measured at 11 months' postpartum did not add to the prediction of infant attachment, over and above that explained by the prenatal WMCI. Implications for these findings are discussed.

This study examined the intergenerational continuities and changes in infant attachment patterns within a higher-risk longitudinal sample of 55 female participants born into poverty. Infant attachment was assessed using the Strange Situation when participants were 12 and 18 months as well as several decades later with participants’ children. Paralleling earlier findings from this sample on the stability of attachment patterns from infancy to young adulthood, results provided evidence for intergenerational continuities in attachment disorganization but not security. Children of adults with histories of infant attachment disorganization were at an increased risk of forming disorganized attachments. Although changes in infant attachment patterns across the two generations were not correlated with individuals’ caregiving experiences or interpersonal stresses and supports during childhood and adolescence, higher quality social support during adulthood was associated with intergenerational changes from insecure to secure infant-caregiver attachment relationships.

��American Psychological Association, 2015. This paper is not the copy of record and may not exactly replicate the authoritative document published in the APA journal. The final article is available, upon publication, at: https://doi.org/10.1037/a0037335, The present study investigated links between the observer-rated process of psychotherapy and 2 key psychotherapy relationship constructs (i.e., working alliance and attachment to the therapist) in the context of a brief, attachment-based, home-visiting, mother���infant intervention that aimed to promote later secure infant attachment. Additionally, links between observer ratings of intervener and mother contributions to process were examined. Participants included 85 economically stressed mothers of first-born, 5.5-month-old, temperamentally irritable infants. Therapists included 2 doctoral-level and 4 master���s-level home visitors. Observer-rated therapist psychotherapy process variables (i.e., warmth, exploration, and negative attitude) were not linked to maternal ratings of working alliance. Therapist warmth, however, was positively associated with maternal ratings of security of attachment to the therapist, and therapist negative attitude was positively related to maternal ratings of preoccupied-merger attachment to the therapist. As expected, both therapist warmth and exploration were positively associated with both maternal participation and exploration. Therapist negative attitude was inversely related to maternal exploration, but not to maternal participation. Results support the idea that attention to the psychotherapy process and relationship may be important in the context of a brief home-visiting parenting intervention with a nonclinical sample. (APA PsycInfo Database Record (c) 2016 APA, all rights reserved)

The Atypical Maternal Behavior Instrument for Assessment and Classification (AMBIANCE; Bronfman, Madigan, & Lyons-Ruth, 2009–2014; Bronfman, Parsons, & Lyons-Ruth, 1992–2004) is a widely used and well-validated measure for assessing disrupted forms of caregiver responsiveness within parent–child interactions. However, it requires evaluating approximately 150 behavioral items from videotape and extensive training to code, thus making its use impractical in most clinical contexts. Accordingly, the primary aim of the current study was to identify a reduced set of behavioral indicators most central to the AMBIANCE coding system using latent-trait item response theory (IRT) models. Observed mother–infant interaction data previously coded with the AMBIANCE was pooled from laboratories in both North America and Europe (N = 343). Using 2-parameter logistic IRT models, a reduced set of 45 AMBIANCE items was identified. Preliminary convergent and discriminant validity was evaluated in relation to classifications of maternal disrupted communication assigned using the full set of AMBIANCE indicators, to infant attachment disorganization, and to maternal sensitivity. The results supported the construct validity of the refined item set, opening the way for development of a brief screening measure for disrupted maternal communication. IRT models in clinical scale refinement and their potential for bridging clinical and research objectives in developmental psychopathology are discussed.

US government-funded early home visiting services are expanding significantly. The most widely implemented home visiting models target at-risk new mothers and their infants. Such home visiting programs typically aim to support infant-parent relationships; yet, such programs' effects on infant attachment quality per se are as yet untested. Given these programs' aims, and the crucial role of early attachments in human development, it is important to understand attachment processes in home visited families. The current, preliminary study examined 94 high-risk mother-infant dyads participating in a randomized evaluation of the Healthy Families Durham (HFD) home visiting program. We tested (a) infant attachment security and disorganization as predictors of toddler behavior problems and (b) program effects on attachment security and disorganization. We found that (a) infant attachment disorganization (but not security) predicted toddler behavior problems and (b) participation in HFD did not significantly affect infant attachment security or disorganization. Findings are discussed in terms of the potential for attachment-specific interventions to enhance the typical array of home visiting services.

This prospective study examined the relationship between maternal prenatal representations of the infant and later infant-mother attachment, including contextual factors related to concordance and discordance among dyads over time. Participants were 173 pregnant women between the ages of 18 and 40 who were interviewed during their last trimester of pregnancy and 2 and 13 months after birth. Maternal representations were assessed by the Working Model of the Child Interview during pregnancy (WMCI; C.H. Zeanah, D. Benoit, L. Hirshberg, M.L. Barton, & C. Regan, 1994), and infant-mother attachment was assessed through the Strange Situation procedure (M.D.S. Ainsworth, M. Blehar, E. Waters, & S. Wall, 1978) when infants were 13 months old. There was substantial discordance between maternal and infant classifications, although a significant concordance rate was found when classifications were collapsed into balanced/secure and nonbalanced/insecure groups based on prenatal representations and postnatal infant attachment groups (60%; χ 2 = 6.90, p< .01; κ .20). As expected, discordance between maternal representations and infant-mother attachment was meaningfully related to contextual risk factors, maternal depression, and infant behaviors. ***

Based on data from the NICHD Study of Early Child Care and Youth Development (N = 1,149), the current article provides the first large-sample investigation of associations between different forms of infant attachment insecurity and dissociative symptomatology from childhood through midadolescence as measured by scales based on the mother, teacher, and youth self-report versions of the Achenbach System of Empirically Based Assessments. Findings did not replicate the previously reported and highly cited evidence that infant attachment disorganization is associated with dissociative symptomatology. In contrast, correlations of small magnitude were observed between infant avoidance and dissociative symptomatology, as assessed by teachers and mothers (but not self-report). Results were not moderated by contextual risk. Limitations of the study included the absence of measures of maltreatment and interpersonal trauma, leaving open the possibility that infant attachment disorganization is a diathesis for later dissociation in the context of severe and/or chronic trauma. Nevertheless, the present results strongly indicate the need for additional research exploring the possible role of environmental factors in the development of dissociative symptomatology.

Background\ud The quality of the early environment is hypothesized to be an influence on morphological development in key neural areas related to affective responding, but direct evidence to support this possibility is limited. In a 22-year longitudinal study, we examined hippocampal and amygdala volumes in adulthood in relation to early infant attachment status, an important indicator of the quality of the early caregiving environment.\ud \ud Methods\ud Participants (N = 59) were derived from a prospective longitudinal study of the impact of maternal postnatal depression on child development. Infant attachment status (24 Secure; 35 Insecure) was observed at 18 months of age, and MRI assessments were completed at 22 years.\ud \ud Results\ud In line with hypotheses, insecure versus secure infant attachment status was associated with larger amygdala volumes in young adults, an effect that was not accounted for by maternal depression history. We did not find early infant attachment status to predict hippocampal volumes.\ud \ud Conclusions\ud Common variations in the quality of early environment are associated with gross alterations in amygdala morphology in the adult brain. Further research is required to establish the neural changes that underpin the volumetric differences reported here, and any functional implications.

The present study investigated the possible differences between foster and comparison parents' state of mind with respect to attachment, and the concordance between caregiver state of mind and child attachment classifications among 60 foster children, all placed before the age of 2 years, as well as 42 comparison children. Caregiver state of mind was measured when the children were 2 years old (Time 1) while child attachment classifications were assessed at age 2 and again at age 3 years (Time 2). The associations between foster children's attachment, age at first and final placements, number of placements, and reasons for placement also were investigated. Descriptive analyses, including cross-tabulations, and independent sample t tests were used. The results showed that the majority of the foster parents had an autonomous state of mind, and no significant group difference between foster and comparison parents was identified. At both time points, most foster children who were classified as secure had autonomous foster parents, as also was the case for the comparison children. The present results are encouraging, suggesting that placing foster children with autonomous foster parents early in life may help them to remain secure over time. Furthermore, focusing on the recruitment of autonomous foster parents is important when working with young foster children.

The aim of this pilot study was to investigate the relationship between maternal insightfulness and sensitivity and subsequent infant attachment security and disorganization in clinically depressed and nonclinical mother-infant groups. Nineteen depressed mothers with infants ages 3 to 11 months participated in this study. Twenty nonclinical mother-infant dyads were matched to the clinical sample according to infant sex and age. Maternal depression was assessed using the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (American Psychiatric Association, 1994), insightfulness using the Insightfulness Assessment (IA), and sensitivity using the Maternal Sensitivity Scales (M.D.S. Ainsworth, 1969). IA classifications and subscales were considered separately. Later infant attachment was assessed by the Strange Situation Procedure (M.D.S. Ainsworth, M.C. Blehar, E. Waters, & S. Wall, 1978). Depressed mothers tended to have less securely attached children than did nonclinical mothers. Within the clinical sample, the insightfulness categories correlated slightly moderately with attachment security, but were not related to attachment disorganization. Within the nonclinical sample, the IA categories were slightly moderately associated with attachment security and with disorganization. On IA subscales, relationship patterns differed in clinically depressed and nonclinical mother-infant dyads. These findings provide the first evidence of the predictive power of the IA categorization and subscales on subsequent infant attachment. They also may allow the development of different foci of intervention for enhancing insightful caregiving.

Infant–caregiver attachment disorganization has been linked to many long-term negative psychosocial outcomes. While various prevention programs appear to be effective in preventing disorganized attachment, methods currently used to identify those at risk are unfortunately either overly general or impractical. The current investigation tested whether women's prenatal biases in identifying infant expressions of emotion—tendencies previously shown to relate to some of the maternal variables associated with infant attachment, including maternal traumatization, trauma symptoms, and maternal sensitivity—could predict infant attachment classification at 18 months postpartum. Logistic regression analyses revealed that together with women's adult history of high betrayal traumatization, response concordance with a normative reference sample in labeling infant expressions as negatively valenced, and the number of infant facial expressions that participants classified as “sad” and “angry” predicted subsequent infant attachment security versus disorganization. Implications for screening and prevention are discussed. RESUMEN La desorganizacion de la afectividad entre infante y quien le cuida ha sido relacionada con muchos resultados sicosociales negativos a largo plazo. Mientras que varios programas de prevencion parecen ser efectivos para prevenir la afectividad desorganizada, los metodos que actualmente se usan para identificar a quienes estan bajo riesgo son, desafortunadamente, o demasiado generales o impracticos. La presente investigacion examino el hecho de si los prejuicios prenatales de las mujeres para identificar las expresiones de emocion del infante –tendencias que, segun se ha demostrado previamente, estan relacionadas con algunas de las variables maternales asociadas con la afectividad del infante, incluyendo el estado traumatico maternal, los sintomas de trauma y la sensibilidad maternal—pudieran predecir la clasificacion de la afectividad del infante a los 18 meses despues del parto. Los analisis de regresion logistica revelaron que, junto con la historia adulta de la mujer de un alto estado traumatico de engano, la concordancia de respuesta con una muestra de referencia normativa al designar las expresiones del infante como de valencia negativa, y el numero de expresiones faciales del infante participantes clasificadas como “tristes” o “furiosas” predijeron la subsecuente seguridad versus desorganizacion en la afectividad del infante. Se discuten las implicaciones para la previa identificacion y la prevencion. RESUME La desorganisation de l’attachement du nourrisson et de la personne qui prend soin de lui a ete liee a de nombreux resultats psychosociaux negatifs. Alors que differents programmes de prevention semble etre efficaces dans la prevention de l’attachement desorganise, les methodes utilisees en ce moment pour identifier ceux ou celles a risques sont malheureusement soit trop generales soit trop peu pratiques. Cette etude a teste si les prejuges prenataux des meres pour ce qui concerne l’identification des expressions d’emotion du nourrisson – tendances dont on a deja demontre qu’elle sont liees a des variables maternelles liees a l’attachement du nourrison, y compris la traumatision maternelle, les symptomes de trauma et la sensibilite maternelle – pouvaient predire la classification d’attachement du nourrisson 18 mois apres la naissance. Les analyses de regression logistique ont revele que, avec l’histoire adulte de traumatisaion de haute trahison, la concordance de reponse avec un echantillon de reference normatif dans l’etiquetage des expressions du nourrisson comme etant negativement valences et le nombre d’expressions faciales du nourrisson classifiees comme etant “triste” ou “en colere” predisait une securite de l’attachement du nourrisson subsequente plutot qu’une desorganisation. Les implications pour le depistage et la prevention sont discutees. ZUSAMMENFASSUNG Bindungsdesorganisation zwischen Sauglingen und ihren Bezugspersonen steht mit vielen langfristigen negativen psychosozialen Folgen im Zusammenhang. Wahrend verschiedene Praventionsprogramme bei der Pravention desorganisierter Bindung wirksam zu sein scheinen, sind die derzeit verwendeten Verfahren zur Identifizierung der gefahrdeten Personen leider entweder zu allgemein oder nicht praktikabel. Es wurde bereits gezeigt, dass einige der mutterlichen Variablen mit der Bindung des Kindes zusammenhangen, einschlieslich mutterlicher Traumatisierung, Trauma-Symptomen und mutterlicher Feinfuhligkeit. Die aktuelle Untersuchung prufte, ob pranatale Wahrnehmungsverzerrungen der Frauen bei der Identifikation von kindlichen Gefuhlsausdrucken die Bindungsklassifikation der Sauglinge 18 Monate nach der Geburt vorhersagen konnten. Die logistischen Regressionsanalysen zeigten, dass – zusammen mit der Lebensgeschichte der Frauen, die von Traumatisierung durch Verrat gepragt war – die Antwortubereinstimmungen mit einer normativen Referenzstichprobe bei der Benennung negativer kindlicher Ausdrucke und die Anzahl der kindlichen Gesichtsausdrucke, die von den Teilnehmern als “traurig” und “bose” eingestuft wurde, die spatere Bindungssicherheit versus Desorganisation des Kindes vorhersagten. Implikationen fur ein Screening und fur Pravention werden diskutiert. ABSTRACT Infant-caregiver attachment disorganization has been linked to many long-term negative psychosocial outcomes. 抄録：乳児と養育者の愛着の無秩序性は、多くの長期にわたるネガティブな精神社会的結果と結びつけられてきた。さまざまな予防プログラムが、無秩序型の愛着を予防する上で有効であると見られるが、リスクのある母子を見つけるために現在使われている方法は、不幸なことに、過度に一般的か、実用的ではない。この調査は、出産前の女性が乳児の情緒表出を同定する際のバイアス－母親の外傷体験、外傷の症状、及び母親の感受性を含む、乳児の愛着と関連するいくつかの母親側の変数として今までに示された傾向－が産後18か月の乳児の愛着分類を予測できるかを調べた。ロジスティック回帰分析によって、女性の大人になってからの高い裏切りによる外傷の歴史とともに、乳児の表出をマイナスの原子価を持つものnegatively-valencedとしてラベル付けする際に正常対照サンプルとの反応の一致と、参加者が「悲しい」および「怒っている」と分類する乳児の表情の数が、後の乳児の愛着の安定性対無秩序性を予測することが、明らかになった。スクリーニングと予防に対して持つ意味が考察される。

The disorganized infant has been described as experiencing “fright without solution” (Hesse & Main, 1999, p. 484) within the attachment relationship. Using a sample at risk because of poverty (n=157), this study evaluated the role of newborn characteristics in predicting disorganized attachment and explored the existence of two subgroups of disorganized infants, based on whether they display direct indices of fear. For the entire sample, regression analyses revealed that newborn characteristics did not predict ratings of disorganization directly or via moderation by caregiving. Regarding subgroups, it was hypothesized that, if direct expressions of fear resulted from interaction with a frightening or frightened caregiver, it could be expected that infants in the Not Frightened subgroup would become disorganized in part because of other factors, such as compromised regulatory abilities at birth. Results supported this hypothesis for emotional regulation, but not for orientation; infants in the Not Frightened subgroup displayed limited emotional regulation as newborns. Findings suggest that the disorganized attachment category may be comprised of two subgroups, with direct expressions of fear as the key differentiating factor. Specifically, disorganized infants who do not display direct fear in the presence of the caregiver may have started out with compromised emotional regulation abilities at birth.

Evidence suggests that maternal borderline personality (BP) pathology increases offspring risk. This study examined the relations between maternal BP pathology and related emotional dysfunction (including emotion regulation [ER] difficulties and emotional intensity/reactivity) and infant ER difficulties. Specifically, we examined both self-focused and caregiver-focused ER behaviors and the modulation of emotional expressions (one indicator of ER in young children) in response to fear- and anger-eliciting stimuli among 101 infants (12 to 23 months old) of mothers with and without clinically relevant BP pathology. The authors also examined the moderating role of mother-infant attachment. Findings of a series of multiple regression mediation analyses revealed an indirect effect of maternal BP pathology on infant ER difficulties through maternal emotional dysfunction, with maternal ER difficulties facilitating an indirect effect of maternal BP pathology on expressivity-related indicators of infant ER difficulties and maternal emotional intensity/reactivity linking maternal BP pathology to lower self-focused ER for infants in insecure-resistant attachment relationships.

Microanalysis research on 4-month infant-mother face-to-face communication operates like a "social microscope" and identifies aspects of maternal sensitivity and the origins of attachment with a more detailed lens. We hope to enhance a dialogue between these two paradigms, microanalysis of mother-infant communication and maternal sensitivity and emerging working models of attachment. The prediction of infant attachment from microanalytic approaches and their contribution to concepts of maternal sensitivity are described. We summarize aspects of one microanalytic study by Beebe and colleagues published in 2010 that documents new communication patterns between mothers and infants at 4 months that predict future disorganized (vs. secure) attachment. The microanalysis approach opens up a new window on the details of the micro-processes of face-to-face communication. It provides a new, rich set of behaviors with which to extend our understanding of the origins of infant attachment and of maternal sensitivity.

Although high rates of attachment disorganization have been observed in infants of depressed mothers, little is known about the role of antenatal depression as a precursor to infant attachment disorganization. The primary aim of this study was to examine associations between maternal antenatal depression and infant disorganization at 12 months in a sample of women (N = 79) at risk for perinatal depression. A secondary aim was to test the roles of maternal postpartum depression and maternal parenting quality as potential moderators of this predicted association. Among women with histories of major depressive episodes, maternal depressive symptoms were assessed at multiple times during pregnancy and the first year postpartum, maternal parenting quality was measured at three months postpartum, and attachment disorganization was assessed at 12 months postpartum. Results revealed that infants classified as disorganized had mothers with higher levels of depressive symptoms during pregnancy compared to infants classified as organized. Maternal parenting quality moderated this association, as exposure to higher levels of maternal depressive symptoms during pregnancy was only associated with higher rates of infant disorganized attachment when maternal parenting at three months was less optimal. These findings suggest that enhancing maternal parenting behaviors during this early period in development has the potential to alter pathways to disorganized attachment among infants exposed to antenatal maternal depressive symptoms, which could have enduring consequences for child wellbeing.

Infants born preterm are at elevated risk for socioemotional difficulties; however, factors contributing to this risk are largely understudied. Within the present study, we explored infant sleep as a biosocial factor that may play a role in infant socioemotional development. Within a prospective longitudinal design, we examined parent-reported sleep patterns and observed parenting quality as predictors of infant-mother attachment in 171 infants born preterm. Using structural equation modeling, we examined main effect and moderator models linking infant sleep patterns and parenting with attachment security. Sleep patterns characterized by more daytime sleep and positive/responsive parenting predicted infant attachment security. Parent-reported nighttime sleep patterns were unrelated to attachment in this sample of infants born preterm. These results indicate that daytime sleep and parenting quality may be important for emerging attachment relationships in infants born preterm. Abstracts translated in Spanish, French, German, and Japanese can be found on the abstract page of each article on Wiley Online Library at

Predictors of infant attachment disorganization were examined among 203 primiparous mothers (52% European American, 48% African American) and their infants (104 female). The Strange Situation Procedure was administered at one year. Global maternal insensitivity and overtly negative maternal behavior were observed during distress-eliciting tasks when infants were six months and one year old. Mothers reported on their demographics to yield a measure of sociodemographic risk (i.e., age, education, income-to-needs). Overtly negative maternal behavior was positively associated with the infant attachment disorganization rating scale score, but did not predict being classified as disorganized. Global maternal insensitivity was associated with higher attachment disorganization, both the rating and the classification, when sociodemographic risk was high but not when sociodemographic risk was low. The pattern of results did not vary by maternal race. The results provide some support for the view that negative maternal behavior and the combination of sociodemographic risk and global maternal insensitivity play a role in the development of infant attachment disorganization.

The present study sought to analyze infant and maternal behavior both during the Strange Situation Procedure (SSP) and a free play session in a Korean sample (N = 87) to help understand whether mother-infant attachment relationships are universal or culture-specific. Distributions of attachment classifications in the Korean sample were compared with a cross-national sample. Behavior of mothers and infants following the two separation episodes in the SSP, including mothers' proximity to their infants and infants' approach to the caregiver, was also observed, as was the association between maternal sensitivity observed during free play session and infant security. The percentage of Korean infants classified as secure versus insecure mirrored the global distribution, however, only one Korean baby was classified as avoidant. Following the separation episodes in the Strange Situation, Korean mothers were more likely than mothers in Ainsworth's Baltimore sample to approach their babies immediately and sit beside them throughout the reunion episodes, even when their babies were no longer distressed. Also, Korean babies less often approached their mothers during reunions than did infants in the Baltimore sample. Finally, the link between maternal sensitivity and infant security was significant. The findings support the idea that the basic secure base function of attachment is universal and the SSP is a valid measure of secure attachment, but cultural differences in caregiving may result in variations in how this function is manifested.

The present study assessed the stability of atypical caregiver behaviors over six years. The sample included 81 mother-child dyads (27 children with cystic fibrosis, 27 with congenital heart disease, and 27 healthy controls). Attachment was assessed using the Strange Situation paradigm when the child was one year old. Atypical caregiver behaviors were assessed in the Strange Situation paradigm at one year and again in a reunion episode at seven years of age using the Atypical Maternal Behavior Instrument for Assessment and Classification (AMBIANCE). Stability of atypical caregiver behaviors over six years was established. Atypical caregiver behaviors assessed when the child was one year old were related to infant-caregiver disorganized attachment and were not associated with secure infant-caregiver attachment. The current study identifies that atypical caregiver behaviors remain stable over time which suggests that they could be targeted during interventions aimed at preventing or treating disorganized child-caregiver attachment relationships and associated negative outcomes.

This randomized controlled trial examined (a) the efficacy of a brief intervention designed to increase the rate of secure infant attachment, (b) the differential susceptibility hypothesis, and (c) whether maternal attachment styles moderated the expected Treatment × Irritability interaction in predicting infant attachment outcomes. Although there was no main effect of treatment, a significant Treatment × Irritability interaction revealed intervention effects for the highly irritable infants only, thus supporting one of two predictions of the differential susceptibility hypothesis: highly irritable infants would have disproportionately better outcomes than moderately irritable infants in better conditions (i.e., with intervention). When separate analyses were conducted with maternal attachment styles, we found significant three-way interactions among treatment, irritability, and each of the examined maternal attachment style dimensions (i.e., secure–fearful and dismissing–preoccupied). Specifically, with more secure mothers, beneficial effects of intervention emerged for highly irritable infants. For more dismissing mothers, the results revealed support for both predictions of the differential susceptibility hypothesis: highly irritable infants, compared to moderately irritable infants, were both more likely to be secure with intervention and less likely to be secure when in the control group. It is interesting that, for more preoccupied mothers, a treatment effect emerged only for moderately irritable infants. We discuss the implications of these findings for the differential susceptibility hypothesis as well as for early intervention.

Starting from an outline of the refugee experience as a process of cumulative traumatisation, we review research literature on mental health outcomes in refugees. Next, an integration of findings on relational processes in refugee families documents the role of the family unit as a key interactive context patterning the impact of sequential traumatisation. Relating these trauma- and migration-specific family processes to their central dimension of provision or disruption of emotional availability in a context of chronic adversity, we aim to explore the development of unresolved and insecure parental states of mind regarding attachment during forced migration. Starting the research report, a method discussion on the administration of 11 Adult Attachment Interviews with adult refugees as part of an explorative multiple case study integrates deontological and technical reflections on the use of the Adult Attachment Interview in a context of ongoing traumatisation. The paper then presents findings on adult attachment in refugees and highlights representational processes involved in the potential disruption of caregiver availability during refugee traumatisation.

This study examined associations between mother–infant nighttime interactions and mother–infant attachment when infants were 12 months old. Forty-four mother–infant pairs participated in this study. For three consecutive nights at home, babies were observed in their cribs using a digital video system. Mothers reported on their nighttime interactions with their babies using a self-report diary and completed a questionnaire regarding child temperament. Attachment was assessed in the Strange Situation (Ainsworth, Blehar, Waters, & Wall, 1978). Mothers of securely attached infants had nighttime interactions that were generally more consistent, sensitive and responsive than those of insecurely attached infants. Specifically, in secure dyads, mothers generally picked up and soothed infants when they fussed or cried after an awakening.

The extent to which indices of maternal physiological arousal (skin conductance augmentation) and regulation (vagal withdrawal) while parenting predict infant attachment disorganization and behavior problems directly or indirectly via maternal sensitivity was examined in a sample of 259 mothers and their infants. Two covariates, maternal self-reported emotional risk and Adult Attachment Interview attachment coherence were assessed prenatally. Mothers' physiological arousal and regulation were measured during parenting tasks when infants were 6 months old. Maternal sensitivity was observed during distress-eliciting tasks when infants were 6 and 14 months old, and an average sensitivity score was calculated. Attachment disorganization was observed during the Strange Situation when infants were 14 months old, and mothers reported on infants' behavior problems when infants were 27 months old. Over and above covariates, mothers' arousal and regulation while parenting interacted to predict infant attachment disorganization and behavior problems such that maternal arousal was associated with higher attachment disorganization and behavior problems when maternal regulation was low but not when maternal regulation was high. This effect was direct and not explained by maternal sensitivity. The results suggest that maternal physiological dysregulation while parenting places infants at risk for psychopathology.

Background: Dyadic interactions between children and depressed mothers have been characterized as less synchronous and with lower maternal sensitivity, fostering an inharmonious, insecure attachment relationship between mother and child. Thus, these children may experience enhanced early life stress and are at higher risk of disturbed socioemotional development. Recently, this association has also been found in women with mild depressive symptoms. However, potential confounding effects of mother's history of own rearing experiences or infant temperament on the link between depressive symptoms and postnatal mother-to-infant attachment have not yet been investigated. Methods: Differences in mother-to-infant attachment (e.g. quality of attachment, absence of hostility, and pleasure in interaction) between mothers with and without symptoms of depression 6-8 months postpartum were analyzed in a low-risk community sample (n = 38, 19 per group). Depressive symptomatology was measured with the Beck Depression Inventory (BDI-II) and the Edinburgh Postnatal Depression Scale (EPDS). Depressed mothers indicated mild-to-moderate depressive symptomatology (mean BDI-II 11.26 ± 3.86) but did not fulfill criteria for a major depressive episode and, thus, were referred to as ‘subclinically' depressed. Potential confounders, namely maternal history of own rearing experiences and infant temperament, were explored by multivariate AN(C)OVA. Results: Primiparous mothers with subclinical depression differed significantly from healthy control mothers, i.e. showed poorer mother-to-infant attachment and higher infant-related hostility 6-8 months postpartum. As expected, infant temperament and mother's history of own rearing experiences were both associated with mother-to-infant attachment but did not explain the negative effects of subclinical depression on the mother-infant relationship. Conclusions: Given the high prevalence of maternal depression, the current findings give reason for increased concern for the developing mother-child relationship. Therefore, early interventions are needed that focus on the mother-child dyad and target not only clinically but also subclinically depressed mothers.

Objectives There were 2 primary objectives to the current study: (1) to relate caregiver behavior trajectories across immunization appointments over the first year of life to subsequent infant attachment and (2) to relate caregiver behavior trajectories within each immunization appointment over the first year of life to subsequent infant attachment. Method A subsample of 130 caregivers and their infants were recruited from a sample of 760 caregivers who were part of an ongoing longitudinal cohort that videotaped infants' 2-, 4-, 6-, and 12-month immunization appointments. This subsample of caregivers and their infants (n = 130) were invited to participate in an assessment of attachment when infants were between 12 and 18 months of age at the local children's hospital. Results Caregiver proximal soothing behaviors were the only caregiver behaviors postimmunization that were related to subsequent infant attachment. Higher frequencies of caregiver proximal soothing at 12 months were related to infants' organized attachment, whereas steeper decreases in proximal soothing across the first year were associated with disorganized infant attachment. In addition, when caregivers engaged in proximal soothing for longer after their 12 month olds' immunizations, these infants were more likely to be secure or organized in their attachment. Conclusion These results provide empirical support for the ecological validity of studying infant attachment in a pediatric pain context. The pediatric "well-baby" visit may provide a potential opportunity to feasibly integrate brief infant mental health screening and intervention.

Although the environmental influences on infant attachment disorganization and security are well-studied, little is known about their heritability. Candidate gene studies have shown small, often non-replicable effects. In this study, we gathered the largest sample (N = 657) of ethnically homogenous, 14-month-old children with both observed attachment and genome-wide data. First, we used a Genome-Wide Association Study (GWAS) approach to identify single nucleotide polymorphisms (SNPs) associated with attachment disorganization and security. Second, we annotated them into genes (Versatile Gene-based Association Study) and functional pathways. Our analyses provide evidence of novel genes (HDAC1, ZNF675, BSCD1) and pathways (synaptic transmission, cation transport) associated with attachment disorganization. Similar analyses identified a novel gene (BECN1) but no distinct pathways associated with attachment security. The results of this first extensive, exploratory study on the molecular-genetic basis of infant attachment await replication in large, independent samples.

Objective: To explore heart rate (HR) correlates of attachment behavior in young mothers and their infants to generate specific hypotheses and to provide pilot data on which studies to test those hypotheses might be based. Method: Using the strange situation procedure, patterns of attachment were assessed in 41 low-income adolescent mothers and their infants. During the procedure, the HRs of the infants and mothers were recorded. The HR changes were analyzed and infant attachment group differences were examined. Results: Infants in all attachment groups demonstrated a similar HR response. There were, however, notably different behavioral reactions in the insecure groups: relatively increased behavioral distress in the insecure/resistant infants and relatively decreased behavioral distress in insecure-avoidant infants. Mothers of insecure-resistant infants demonstrated elevated HRs during reunions and the insecure/resistant dyads demonstrated lower consistency between HR changes in infant and mother than the secure dyads. Conclusions: The results suggest the discrepancy between attachment-related behavioral reactions and HR response in insecurely attached infants. Maternal and dyadic HR changes vary between the attachment groups. J. Am. Acad. Child Adolesc. Psychiatry, 2005;44(5):470–476.

New laboratory research has begun to reveal a network of simple behavioral, physiological and neural processes that underlie the psychological constructs of attachment theory. It has become apparent that the unique features of early infant attachment reflect certain unique features of early infant sensory and motor integration, early learning, communication, motivation and the regulation of biobehavioral systems by the mother–infant interaction. This chapter will undertake to answer three major questions that have remained unsettled in our understanding of early human attachment: How does the infant find its own mother and stay close to her? Why does separation of the infant from its mother produce such severe physiologic and behavioral responses? How can individual differences in adult offspring and especially in their maternal behavior toward their own infants be related to the patterns of early life with their parents? In each of these cases, I will review the recent research that has given us new answers to these questions at the level of early behavioral, affective and cognitive processes and their neurobiological substrates. Attachment remains useful as a concept, like hunger, that describes the operation of subprocesses that work together within the frame of a vital biological function.