Introduction: Secure attachment in adolescence, related to caregiving quality, is a robust predictor of positive behavioral adjustment in early adulthood and beyond. Nevertheless, few attempts have been made to develop treatments to promote parent-adolescent attachment security. Methods: Using a longitudinal, multicenter, randomized controlled trial design, two questionnaire-based studies were run in Italy (Study 1: n = 100 mothers of adolescents, 60% boys, M age = 14.89, SD = 1.58; Study 2: n = 40 mothers and 40 adolescents, 60% boys, M age = 14.90, SD = 1.91) to test the effectiveness of an attachment-based parenting intervention (i.e., Connect) in reducing adolescents' behavioral problems and attachment insecurity 2 weeks postintervention (t2) and at a 4-month follow-up (t3). It was further investigated whether a decrease in avoidant and anxious attachment at t2 would account for changes in externalizing and internalizing problems, respectively, at t3. All adolescents belonged to two-parent intact families. Results: Mothers who completed Connect reported signiicantly fewer adolescent behavioral problems and lower adolescent attachment insecurity, compared to mothers in the waitlist group, at both t2 and t3 (Study 1). These indings were conirmed in a second subsample (Study 2), considering both mothers' and adolescents' reports. Controlling for pre-intervention behavioral problems, reductions in internalizing and externalizing problems were observed in both studies at t3 via a decrease in anxious and avoidant attachment, respectively, at t2. Conclusions: The indings point to the malleability of attachment security in adolescence and highlight the importance of targeting parenting quality to promote adolescent behavioral adjustment.
Autism spectrum disorder (ASD) is a heterogeneous clinical condition whose prevalence has grown considerably during the last decade. Genetic factors are thought to underpin the disorder, but common genetic variants and epigenetic mechanisms have been increasingly called into question for the majority of ASD cases. Growing prenatal exposure to new environmental toxicants has been shown to potentially affect brain development, leading to altered cognitive, social, attentive, behavioral, and motor performance. Both epidemiological evidence and mechanistic studies assessing oxidative stress, neuroinflammation, epigenetic alterations, and impaired signal transduction, all observed following neurotoxicant exposure, indeed lend biological plausibility to Gene x Environment interactions, whereby environmental toxicants interacting additively or synergistically with genetic liability, can push prenatal neurodevelopmental processes over the threshold for postnatal ASD expression. Research on environmental contributions to ASD and on specific Gene x Environment interaction models ultimately aims at defining targeted preventive strategies.
Adolescents' challenges could be effectively addressed by treating their parents. Prior evaluations of CONNECT, an attachment-based program intervention for parents of adolescents at risk, indicated that improving parenting skills and the quality of parent-adolescent relationship may result in decrease of adolescents' behavioural problems. The present study is part of a longitudinal research involving three Italian centres (Pavia, Milan, Pisa) aimed at investigating whether helping parents reduce their reliance on coercive or unproductive parenting strategies and understand changes occurring during adolescence from an attachment-based perspective would reduce their adolescents' externalizing and internalizing symptoms. One-hundred and eighteen parents of adolescents (Mage = 15.26 years, SD = 1.49; 64% boys), randomly assigned to the intervention group (n = 66) or to the wait-list control group (n = 52), reported on their perceptions of their adolescents' externalizing and internalizing symptoms (using the Strength and Difficulties Questionnaire-parent version; Goodman, 1997), as well as attachment avoidance and attachment anxiety (using the Adolescent Attachment Anxiety & Avoidance Inventory; Moretti and Obsuth, 2009) prior to treatment (t0), within a two-week period following the final treatment session (t1) and at a four months follow-up (t2). Parents attending the CONNECT program reported significant reductions in their adolescents' externalizing symptoms, and slightly significant reductions in their adolescents' internalizing symptoms by a reduction of anxiety and avoidance attachment strategies. The findings add evidence to the importance of investigating mechanisms of change underlying the effectiveness of CONNECT program, providing further indications on its application in therapeutic contexts.
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