Poster #168 - The Moderating Role of Secure Base Script Knowledge on the Effectiveness of ABC, an Attachment-Based Intervention

• In Event: 2-110 - Poster Session 07
  In Poster Session: PS 07 Section - Prevention and Interventions

Integrative Statement

Identifying moderators of intervention effectiveness is of great clinical importance, as these efforts help determinine what interventions work for whom.
Attachment and Biobehavioral Catch-up (ABC; Dozier et al., 2013), an attachment-based intervention for infants exposed to early adversity, has strong evidence of effectiveness: children show increased rates of secure attachment (Bernard et al., 2012) and improved self-regulation (Bernard, Hostinar, & Dozier, 2015; Lind et al., 2017). The purported mechanism of change in ABC is improved parental sensitivity, a hypothesis supported in randomized clinical trials (Bernard, Simons, & Dozier, 2015) and when implemented by community clinicians (Roben, Dozier, Caron, & Bernard, 2017). That said, not all parents (and children) benefit equally from ABC, necessitating the exploration of predictors of differential response to the intervention. Given that sensitive parenting is influenced by one’s own history of caregiving, parents’ attachment representations may be one moderator of ABC’s effectiveness. The secure base script is a mental representation that reflects a sequence of attachment-relevant events that follow a distressing event, from seeking support to effective resolution and return to exploration (Waters & Waters, 2006). Secure base script knowledge may provide a basic framework about sensitive parent-child interactions that supports learning and applying the targets of ABC in one’s own interactions with their children. In the current study, we examined whether parents’ secure base script knowledge moderated the effectiveness of ABC on parental sensitivity.
In the context of community-based implementation, 200 parents and infants were enrolled in a randomized clinical trial and randomly assigned to receive ABC or be placed on a waitlist. At baseline and post-intervention, parents and children were video-recorded in a play interaction, which was coded for parental sensitivity (NICHD Early Child Care Research Network, 1999, 2003). Parents also completed the Attachment Script Assessment (ASA, Waters & Rodrigues-Doolabh, 2001), which was coded for secure base script knowledge. Data analyses were based on 65 parents with complete data, though remaining data will be available for presentation at the time of the conference.
A moderation analysis was conducted using PROCESS 2.041 in SPSS, with group (ABC vs. waitlist) as the predictor, parental sensitivity at post as the outcome, secure base script knowledge as the moderator, while accounting for covariates (i.e., parental sensitivity at baseline, composite sociodemographic risk). Results indicated that secure base script knowledge significantly moderated the effect of ABC on changes in parental sensitivity. At low levels of secure base script knowledge (-1 SD below mean), the effect of ABC on parental sensitivity was non-significant, b = -.13, p = .67, whereas at high levels of secure base script knowledge (+1 SD above mean), the effect of ABC on parental sensitivity was significant, b = .80, p = .009 (See Figure 1).
These findings suggest that ABC may be most effective for caregivers who have already internalized the secure base script. This sample is drawn from a high-risk community, so it is possible that environmental stress undermines sensitivityand ABC acts as a primer of the script. Future research might explore the mechanism behind this finding and additional moderators of ABC’s effectiveness.

Authors

• Steven Imrisek, Stony Brook University
  Presenting Author

• Allison Dash, Power of Two
  Non-Presenting Author

• Galia Nissim, Stony Brook University
  Non-Presenting Author

• Melanie Rodriguez, Stony Brook University
  Non-Presenting Author

• Kristin Bernard, Stony Brook University
  Non-Presenting Author