Sustained Effects on Attachment Quality in Middle Childhood: The Attachment and Biobehavioral Catch-Up Intervention

• In Event: 2-025 - Attachment and Caregiving Dysregulation: Neural Correlates, Sequelae, and an Effective Intervention

Integrative Statement

Children are at increased risk for developing disorganized attachments when they experience frightening or frightened caregiving (Main & Hesse, 1990). This is problematic because disorganized attachments are a robust predictor of later externalizing and internalizing symptoms (Fearon et al., 2010). The Attachment and Biobehavioral Catch-Up (ABC; Dozier et al., 2016) intervention was developed to decrease frightening behaviors and increase sensitive caregiving. ABC has been shown to enhance attachment quality among maltreated children (Bernard et al., 2012), improve children’s emotional and physiological regulation (Bernard et al., 2015; Lind et al., 2014), and increase parental sensitivity (Bick & Dozier, 2013). Other interventions (e.g., Child-Parent Psychotherapy) have been developed to promote attachment quality in maltreated children (Stronach et al., 2013). Attachment is typically assessed as a short-term outcome rather than a long-term outcome. This study examined whether disorganized attachment in infancy predicted lower ratings of perceived attachment security at age nine and whether children who received ABC as infants reported higher ratings of perceived attachment security at age nine than children who received a control intervention.
Participants included 100 children whose parents were referred to Child Protective Services due to allegations of maltreatment (see Table 1). Parents were randomized to receive ABC or a control intervention. Both ABC and the control consisted of 10 hour-long sessions delivered weekly in families’ homes. ABC focused on promoting caregiving quality, whereas the control focused on children’s cognitive and motor development. After receiving the intervention, children completed the Strange Situation (Ainsworth et al., 1978). Children were classified as disorganized if they met the threshold for disorganized behaviors (e.g., freezing or disoriented wandering) when reuniting with their parents (Main & Solomon, 1990). When children were nine, the Kerns Security Scale (Kerns, Klepac, & Cole, 1996) assessed children’s perceptions of whether an attachment figure is responsive and reliable, their sense that they could rely on the attachment figure when distressed, and their indicated ease and interest in communicating with the attachment figure. Children’s responses on the Security Scale were averaged to create an overall rating of perceived attachment security.
Strange Situation data were available for 80 children who completed the Security Scale. Forty-eight children were classified as organized, and 32 children were classified as disorganized. An independent samples t-test of children’s attachment ratings revealed that children who received ABC had higher ratings of perceived attachment security (M = 3.49, SD = .38) at age nine than children who received the control intervention (M = 3.28, SD = .47), t(98) = 2.38, p = .02, d = 0.49. Children who were classified as having disorganized attachments in infancy had lower ratings of perceived attachment security in middle childhood (M = 3.17, SD = .53) than children who had organized attachments (M = 3.48, SD = .36), t(78) = -3.14, p < .01, d = 0.68. Attachment quality and intervention group did not interact to predict perceived attachment security ratings. Results suggest that ABC is efficacious in promoting attachment quality beyond infancy to middle childhood and highlight the importance of early intervention.

Authors

• Lindsay Zajac, University of Delaware
  Presenting Author

• Lee Raby, University of Utah
  Non-Presenting Author

• Mary Dozier, University of Delaware
  Non-Presenting Author