Poster #159 - Associations Between Mother-Preschooler Attachment and Maternal Depression and Anxiety: A Systematic Review and Meta-Analysis

• In Event: 1-115 - Poster Session 03
  In Poster Session: PS 03 Section - Parenting & Parent-Child Relationships

Integrative Statement

Introduction: When a mother experiences mental illness, the impact can resonate throughout the entire family. The developing child is particularly vulnerable, as the mother’s ability to be physically and emotionally responsive to her child’s needs can be compromised (Lovejoy et al., 2000). Maternal mental health challenges have been hypothesized to affect the mother-child attachment relationship by undermining a mother’s ability to engage in sensitive caregiving. Supporting this, meta-analytic evidence has identified associations between maternal depression and insecure infant attachment behaviors, suggesting that infants of depressed mothers are less likely to approach or be effectively comforted by their mother when the infant is emotionally distressed (Atkinson et al., 2000). However, our understanding of how maternal mental illness impacts attachment beyond infancy, during the preschool years, is limited. Given that preschool-age children are in the process of transitioning from caregiver-directed emotion regulation to self-directed emotion regulation, it is important to understand the extent to which maternal mental health challenges are associated with preschoolers’ attachment behaviors, in order to ensure that this risk factor, if present, is appropriately managed.

Aim: The current study aimed to systematically review and meta-analyze concurrent and longitudinal associations between maternal depression and anxiety symptoms and mother-child attachment during the preschool period (2 to 7 years) as assessed using the coding systems by Cassidy and Marvin (1992) and Main and Cassidy (1988).

Hypotheses: We expected higher levels of maternal mental illness to be associated with preschooler attachment insecurity. Furthermore, we expected sample type to moderate the relationship between maternal mental illness and preschooler attachment insecurity, such that studies using clinical samples would yield larger effect sizes than studies using normative samples.

Methods: The review was pre-registered with PROSPERO (International Prospective Register of Systematic Reviews; Registration number Registration number: XXXX) and was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. In total, 7,969 records were screened and 20 articles were deemed as eligible for inclusion in the review. Studies were reviewed using qualitative synthesis techniques and, where appropriate, meta-analysis and meta-regression (examining the moderating role of sample type, gender, and risk of bias).

Results: Qualitative synthesis indicated that mothers of disorganized/controlling children most consistently reported the most depressive symptoms, both concurrently and longitudinally. The association between disorganized/controlling child attachment and concurrent maternal depressive symptoms was significant (n = 1,778; g = 0.27, 95% CI [0.13,0.40]), and was not moderated by sample type, child gender, or risk of bias. Findings of a relationship between child attachment insecurity and maternal depressive symptoms (n = 1,595; g = 0.30, 95% CI [0.06,0.55]) must be qualified due to significant within-study heterogeneity and publication bias. No significant association was found between maternal anxiety symptoms and child attachment.

Discussion: Results suggest that maternal depressive symptoms may confer additional risk for disorganized/controlling attachment, more so than insecure attachment generally, during the preschool period. Findings highlight the importance of maternal mental health screening and intervention, particularly early in the child’s life, as a strategy for supporting adaptive child development.

Authors

• Shaylea Badovinac, York University
  Presenting Author

• Jodi Martin, York University
  Non-Presenting Author

• Camille Guérin-Marion, University of Ottawa
  Non-Presenting Author

• Monica O'Neill, York University
  Non-Presenting Author

• Rebecca Pillai Riddell, York University
  Non-Presenting Author

• Jean-Francois Bureau, University of Ottawa
  Non-Presenting Author

• Rebecca Spiegel, York University
  Non-Presenting Author