Increasing secure base script knowledge among parents with Attachment and Biobehavioral Catch-up

Attachment expectations moderate links between social support and maternal adjustment from 6 to 18 months postpartum

Significant links exist between one's perception of available social support and mental health outcomes, including during the transition to motherhood. Yet, attachment theory posits that individuals do not benefit equally from social support. As such, we examined the influence of attachment representations (i.e., secure base script knowledge) as they potentially moderate links between social support and psychological distress in a 1-year longitudinal study of an ethnically diverse (56% White) sample of infant-mother dyads. We hypothesized that higher social support would predict lower maternal psychological distress and this relation would be strongest in those with higher secure base script knowledge. Results indicated that maternal perceptions of social support were significantly negatively correlated with psychological distress. Analyses revealed that secure base script scores significantly moderated these associations. Interestingly, for those high in script knowledge, low social support predicted greater psychological distress. For those low in script knowledge, social support was unrelated to psychological distress. This pattern suggested that those who expect care (i.e., high secure base script knowledge) but receive minimal support (i.e., low perceived social support) find motherhood uniquely dysregulating. Practitioners may do well to examine individuals' attachment expectations in relation to their current social support.

Using randomized controlled trials to ask questions regarding developmental psychopathology: A tribute to Dante Cicchetti

Dante Cicchetti, the architect of developmental psychopathology, has influenced so many of us in profound ways. One of his many contributions was in demonstrating the power of randomized controlled trials (RCTs) to study the effects of Child-Parent Psychotherapy (CPP). These RCTs have shed light on causal mechanisms in development. Following Cicchetti and colleagues' work, we designed a brief home visiting program, Attachment and Biobehavioral Catch-up (ABC), to help parents respond in sensitive, nurturing ways, so as to enhance children's attachment and self-regulatory capabilities. In the current study, we assessed adolescents' reports of the closeness of their relationships with their mothers 12 years after their mothers completed the intervention. A total of 142 adolescents participated (47 randomized to ABC, 45 randomized to a control intervention, and 50 from a low-risk comparison group). Adolescents whose mothers had been randomized to ABC reported closer relationships with their mothers than adolescents randomized to the control condition, with significant differences seen on approval, support, companionship, and emotional support subscales. Consistent with Cicchetti et al.'s work, these results provide powerful evidence of the long-term effects of an early parenting intervention.

A cognitive script perspective on how early caregiving experiences inform adolescent peer relationships and loneliness: A 14-year longitudinal study of Chinese families

Leveraging data from a longitudinal study of Chinese families (n = 364), this research aims to understand the role of secure base script knowledge as a cognitive mechanism by which early caregiving experiences inform adolescents' friendship quality and feelings of loneliness. Results showed that observed maternal sensitivity at 14 and 24 months old was negatively associated with adolescents' self-reported conflicts with close friends (β = -0.17, p = 0.044) at 15 years old, and this association was partially mediated by their secure base script knowledge assessed at 10 years old. Further, secure base script knowledge moderated the link between adolescents' friend conflict and feelings of loneliness (β = -0.15, p = 0.037). The results support a cognitive script perspective on the association between early caregiving experiences and later socio-emotional adjustment. Furthermore, this study adds to the developmental literature that has previously focused on more stringent and authoritarian aspects of parenting in Chinese families, thereby contributing to our understanding of how sensitive and supportive parenting practices contribute to socio-emotional development outside of Western contexts. RESEARCH HIGHLIGHTS: Maternal sensitivity during infancy and toddlerhood has a long-term association with adolescents' friendship quality and adolescents' secure base script partially explains the association. First evidence to demonstrate that the secure base script in attachment relationships mediates the association between early maternal caregiving and socio-emotional development in Chinese adolescents. Adolescents lacking secure base script knowledge are particularly vulnerable to feelings of loneliness when facing high levels of conflict in close friendships.

Probing the content of affective semantic memory following caregiving-related early adversity

Cognitive science has demonstrated that we construct knowledge about the world by abstracting patterns from routinely encountered experiences and storing them as semantic memories. This preregistered study tested the hypothesis that caregiving-related early adversities (crEAs) shape affective semantic memories to reflect the content of those adverse interpersonal-affective experiences. We also tested the hypothesis that because affective semantic memories may continue to evolve in response to later-occurring positive experiences, child-perceived attachment security will inform their content. The sample comprised 160 children (ages 6-12 at Visit 1; 87F/73 M), 66% of whom experienced crEAs (n = 105). At Visit 1, crEA exposure prior to study enrollment was operationalized as parental-reports endorsing a history of crEAs (abuse/neglect, permanent/significant parent-child separation); while child-reports assessed concurrent attachment security. A false memory task was administered online ∼2.5 years later (Visit 2) to probe the content of affective semantic memories-specifically attachment schemas. Results showed that crEA exposure (vs. no exposure) was associated with a higher likelihood of falsely endorsing insecure (vs. secure) schema scenes. Attachment security moderated the association between crEA exposure and insecure schema-based false recognition. Findings suggest that interpersonal-affective semantic schemas include representations of parent-child interactions that may capture the quality of one's own attachment experiences and that these representations shape how children remember attachment-relevant narrative events. Findings are also consistent with the hypothesis that these affective semantic memories can be modified by later experiences. Moving forward, the approach taken in this study provides a means of operationalizing Bowlby's notion of internal working models within a cognitive neuroscience framework. RESEARCH HIGHLIGHTS: Affective semantic memories representing insecure schema knowledge (child needs + needs-not-met) may be more salient, elaborated, and persistent among youths exposed to early caregiving adversity. All youths, irrespective of early caregiving adversity exposure, may possess affective semantic memories that represent knowledge of secure schemas (child needs + needs-met). Establishing secure relationships with parents following early-occurring caregiving adversity may attenuate the expression of insecure semantic memories, suggesting potential malleability. Affective semantic memories include schema representations of parent-child interactions that may capture the quality of one's own attachment experiences and shape how youths remember attachment-relevant events.

The impact of the "Attachment and Biobehavioural Catch-Up" program on attachment related parent behavior-A systematic review

"Attachment and Biobehavioural Catch-Up" (ABC) is a 10 session home visiting program, grounded in attachment theory. It aims to improve child emotion regulation, attachment and behavioral outcomes through changing caregivers' attachment related behaviors. There is increasing evidence with respect to the effectiveness of ABC in producing positive child outcomes, but the intervention's direct effect on parent outcomes remains unclear. This review examined the association of ABC with attachment related parent outcomes. The PubMed, EMBASE, PyschINFO and SCOPUS databases were searched for relevant studies in August 2021, and again in April 2022. The eligibility criteria for included studies were (1) infants aged 0-27 months at time of the ABC intervention, (2) "at risk" parents, (3) controlled trials published in peer-reviewed journals and (4) utilized a measure of attachment related parent outcomes. Eleven eligible studies were included. The findings showed ABC had a significant small to medium effect on a variety of attachment related parent outcomes among parents presenting with multiple psychosocial risk factors. "Sensitivity" was measured most frequently, with small to medium main effect sizes recorded at follow-up, compared to controls. Implications for the clinical effectiveness of the ABC program in community settings are discussed. Future research should clarify who ABC is most effective for and how it compares to similar interventions.

Mothers’ Attachment Representations and Children’s Brain Structure

Ample research demonstrates that parents’ experience-based mental representations of attachment—cognitive models of close relationships—relate to their children’s social-emotional development. However, no research to date has examined how parents’ attachment representations relate to another crucial domain of children’s development: brain development. The present study is the first to integrate the separate literatures on attachment and developmental social cognitive neuroscience to examine the link between mothers’ attachment representations and 3- to 8-year-old children’s brain structure. We hypothesized that mothers’ attachment representations would relate to individual differences in children’s brain structures involved in stress regulation—specifically, amygdala and hippocampal volumes—in part via mothers’ responses to children’s distress. We assessed 52 mothers’ attachment representations (secure base script knowledge on the Attachment Script Assessment and self-reported attachment avoidance and anxiety on the Experiences in Close Relationships scale) and children’s brain structure. Mothers’ secure base script knowledge was significantly related to children’s smaller left amygdala volume but was unrelated to hippocampal volume; we found no indirect links via maternal responses to children’s distress. Exploratory analyses showed associations between mothers’ attachment representations and white matter and thalamus volumes. Together, these preliminary results suggest that mothers’ attachment representations may be linked to the development of children’s neural circuitry related to stress regulation.

An empirical test of prototype and revisionist models of attachment stability and change from middle childhood to adolescence: A 6-year longitudinal study

We examined the prototype v. revisionist models of attachment stability with a five-wave, 6-year, longitudinal study of attachment security from middle childhood to adolescence in a White Western European sample (N = 157; Wave 1 M_age  = 10.91, SD = 0.87; 52% female). Attachment was assessed using both questionnaire (Experiences in Close Relationships) and narrative-based measures (Attachment Script Assessment). In addition, a set of potential moderators of prototype-like stability were examined. Results indicated that data from both attachment assessments best fit the prototype model. Moderator analyses indicated that male sex significantly undermined the influence of an attachment prototype and parent-child conflict and parental divorce enhanced the influence of an attachment prototype on stability.

Adapting an Evidence-Based Home Visiting Intervention for Mothers With Opioid Dependence: Modified Attachment and Biobehavioral Catch-up

Infants born to mothers who are dependent on opioids often have difficulty regulating behavior and physiology at birth. Without sensitive maternal care, these infants are at risk for ongoing problems with self-regulation. Mothers who are dependent on opioids may experience challenges related to their substance use (e.g., unsupportive and/or risky environment, impulse control and reward system problems) that increase the likelihood of insensitive parenting in the absence of effective intervention. In this paper, we describe a home-visiting intervention we have adapted to enhance sensitive, responsive caregiving tailored to the specific needs of mothers with opioid dependence. The original intervention, Attachment and Biobehavioral Catch-up (ABC), was designed for mothers of infants aged 6-24 months who were exposed to early adversity. ABC has been shown to enhance sensitive parenting as well as children's behavioral and biological functioning, with positive outcomes extending into at least middle childhood. Mothers who are opioid dependent need earlier support than provided by ABC because opioid-exposed infants are often vulnerable at birth. The adapted intervention (modified ABC or mABC) includes one prenatal session and one early postnatal session, followed by 10 sessions every 2-3 weeks. In the initial two sessions in particular, mothers are helped to anticipate the challenges of caring for a baby who may be difficult to soothe while nonetheless providing sensitive care. mABC is intended to help mothers see the importance of responding sensitively so as to help infants overcome the developmental risks associated with opioid exposure. Additionally, mABC is structured to support mothers with the challenges of early parenting, especially if the mother herself was not parented sensitively. Throughout, the focus is on helping the mother nurture the distressed infant, attend to the infant's signals, and avoid behaving in overstimulating or intrusive ways. Case examples are presented that highlight both the challenges of working with this population as well as the gains made by mothers.