Enhancing infant attachment security: An examination of treatment efficacy and differential susceptibility

Cassidy, Jude; Woodhouse, Susan S.; Sherman, Laura J.; Stupica, Brandi; Lejuez, Carl W.

doi:10.1017/s0954579410000696

Cited by 179 publications

(184 citation statements)

References 46 publications

Supporting

Mentioning

167

Contrasting

Order By: Relevance

“…Specifically, the intervention was most effective for mothers with highly reactive infants; on the other hand, for mothers with low reactive infants, there was no association between gains in maternal sensitivity and attachment security. Similar specification of intervention effects has been observed using infant irritability and child negative emotionality as ES moderators [38][39][40]. The same investigators also provided the first data on a genetically informed ES intervention.…”

Section: Experimental Evidence Of Esmentioning

confidence: 66%

Application of environmental sensitivity theories in personalized prevention for youth substance abuse: a transdisciplinary translational perspective

Thibodeau

August

Cicchetti

et al. 2015

Behav. Med. Pract. Policy Res.

View full text Add to dashboard Cite

Preventive interventions that target high-risk youth, via one-size-fits-all approaches, have demonstrated modest effects in reducing rates of substance use. Recently, substance use researchers have recommended personalized intervention strategies. Central to these approaches is matching preventatives to characteristics of an individual that have been shown to predict outcomes. One compelling body of literature on person × environment interactions is that of environmental sensitivity theories, including differential susceptibility theory and vantage sensitivity. Recent experimental evidence has demonstrated that environmental sensitivity (ES) factors moderate substance abuse outcomes. We propose that ES factors may augment current personalization strategies such as matching based on risk factors/severity of problem behaviors (risk severity (RS)). Specifically, individuals most sensitive to environmental influence may be those most responsive to intervention in general and thus need only a brief-type or lower-intensity program to show gains, while those least sensitive may require more comprehensive or intensive programming for optimal responsiveness. We provide an example from ongoing research to illustrate how ES factors can be incorporated into prevention trials aimed at high-risk adolescents. Keywords Substance use, Prevention, Environmental sensitivity, R i s k s e v e r i t y, D i ff e r e n t i a l s u s c e p t i b i l i t y, PersonalizationAlcohol and other drug use among adolescents is a serious public health concern in the USA. For example, by late adolescence, over 78 % of teens will have experimented with alcohol, over 47 % will be engaged in regular drinking habits, and over 14 % will have met criteria for lifetime abuse [1]. Despite herculean efforts over the previous five decades to stem the rising tide of substance use, treatment approaches (largely based on behavioral parent training and cognitive behavioral therapy principles) have been modest at best; there is considerable variability in outcomes, and no one model works similarly for all youth [2]. Even among those who experience initial success following treatment, relapse rates are high [3].

show abstract

Section: Experimental Evidence Of Esmentioning

confidence: 66%

Application of environmental sensitivity theories in personalized prevention for youth substance abuse: a transdisciplinary translational perspective

Thibodeau

August

Cicchetti

et al. 2015

Behav. Med. Pract. Policy Res.

View full text Add to dashboard Cite

show abstract

“…For example, the Strengthening Families Program (SFP) has received mixed support for improving family environment (Molgaard and Spoth, 2001;Riesch et al, 2012); whereas Circle of Security (COS), an intervention designed to promote parent-child attachment, has demonstrated improvements only in a few small studies to date (Hoffman et al, 2006;Cassidy, Ziv, et al, 2010;Cassidy, Woodhouse, et al, 2011). Some other approaches have been evaluated only in open trials, including the Attachment, Self-Regulation, and Competency (ARC) model (Arvidson et al, 2011;Hodgdon, Kinniburgh, et al, 2013) and Strengthening Family Coping Resources (SFCR) (Kiser, Donohue, et al, 2010;Kiser, Backer, et al, 2015).…”

Section: State Of the Evidence For Improving Outcomes For Children Exmentioning

confidence: 99%

Improving Outcomes for Children Exposed to Violence: Safe Start Promising Approaches

Schultz¹,

Jaycox²,

Ayer³

et al. 2017

View full text Add to dashboard Cite

“…In total, 30 studies were identified, 175,178,[180][181][182][183][184]188,189,191,[194][195][196]198,[200][201][202][203][205][206][207][208]211,212,218 29 of which were delivering an intervention in a hypothesised 'at-risk' group to improve attachment security 129,[175][176][177][178][180][181][182][183][184][185][186]189,191,[194][195][196]198,[200][201][202][203]205,206,208,211,…”

Section: Main Systematic Reviewmentioning

confidence: 99%

“…188 The studies were published between 1985 and 2012 and were undertaken in a variety of countries: five in the UK, 176,188,189,207,208 14 in the USA, 177,[180][181][182][184][185][186]191,194,196,200,201,205,211 three in the Netherlands, 178,198,203 three in Canada, 175,195,218 one in Germany, 202 one in Australia, 130 one in Italy, 206 one in Finland 212 and one in Lithuania. 183 l Eight studies were identified in the main systematic review that evaluated the intervention using a measure that assessed a disorganised pattern.…”

Section: Main Systematic Reviewmentioning

confidence: 99%

“…183 l Eight studies were identified in the main systematic review that evaluated the intervention using a measure that assessed a disorganised pattern. 189,190,[194][195][196]198,200,218 l Only one study was identified that was focused on a population of children with an attachment disorder diagnosis. 187 l The remaining 21 studies evaluated the interventions with a measure that assessed only secure and insecure attachment patterns without a disorganised group.…”

Section: Main Systematic Reviewmentioning

confidence: 99%

See 1 more Smart Citation

Clinical effectiveness and cost-effectiveness of parenting interventions for children with severe attachment problems: a systematic review and meta-analysis

Wright

Barry

Hughes

et al. 2015

Health Technol Assess

View full text Add to dashboard Cite

Background and objectivesServices have variable practices for identifying and providing interventions for ‘severe attachment problems’ (disorganised attachment patterns and attachment disorders). Several government reports have highlighted the need for better parenting interventions in at-risk groups. This report was commissioned to evaluate the clinical effectiveness and cost-effectiveness of parenting interventions for children with severe attachment problems (the main review). One supplementary review explored the evaluation of assessment tools and a second reviewed 10-year outcome data to better inform health economic aspects of the main review.Data sourcesA total of 29 electronic databases were searched with additional mechanisms for identifying a wide pool of references using the Cochrane methodology. Examples of databases searched include PsycINFO (1806 to January week 1, 2012), MEDLINE and MEDLINE In-Process & Other Non-Indexed Citations (1946 to December week 4, 2011) and EMBASE (1974 to week 1, 2012). Searches were carried out between 6 and 12 January 2012.Review methodsPapers identified were screened and data were extracted by two independent reviewers, with disagreements arbitrated by a third independent reviewer. Quality assessment tools were used, including quality assessment of diagnostic accuracy studies – version 2 and the Cochrane risk of bias tool. Meta-analysis of randomised controlled trials (RCTs) of parenting interventions was undertaken. A health economics analysis was conducted.ResultsThe initial search returned 10,167 citations. This yielded 29 RCTs in the main review of parenting interventions to improve attachment patterns, and one involving children with reactive attachment disorder. A meta-analysis of eight studies seeking to improve outcome in at-risk populations showed statistically significant improvement in disorganised attachment. The interventions saw less disorganised attachment at outcome than the control (odds ratio 0.47, 95% confidence interval 0.34 to 0.65;p < 0.00001). Much of this focused around interventions improving maternal sensitivity, with or without video feedback. In our first supplementary review, 35 papers evaluated an attachment assessment tool demonstrating validity or psychometric data. Only five reported test–retest data. Twenty-six studies reported inter-rater reliability, with 24 reporting a level of 0.7 or above. Cronbach’s alphas were reported in 12 studies for the comparative tests (11 with α > 0.7) and four studies for the reference tests (four with α > 0.7). Three carried out concurrent validity comparing the Strange Situation Procedure (SSP) with another assessment tool. These had good sensitivity but poor specificity. The Disturbances of Attachment Interview had good sensitivity and specificity with the research diagnostic criteria (RDC) for attachment disorders. In our supplementary review of 10-year outcomes in cohorts using a baseline reference standard, two studies were found with disorganised attachment at baseline, with one finding raised psychopathology in adolescence. Budget impact analysis of costs was estimated because a decision model could not be justifiably populated. This, alongside other findings, informed research priorities.LimitationsThere are relatively few UK-based clinical trials. A 10-year follow-up, while necessary for our health economists for long-term sequelae, yielded a limited number of papers.ConclusionsMaternal sensitivity interventions show good outcomes in at-risk populations, but require further research with complex children. The SSP and RDC for attachment disorders remain the reference standards for identification until more concurrent and predictive validity research is conducted. A birth cohort with sequential attachment measures and outcomes across different domains is recommended with further, methodologically sound randomised controlled intervention trials. The main area identified for future work was a need for good-quality RCTs in at-risk groups such as those entering foster care or adoption.Study registrationThis study is registered as PROSPERO CRD42011001395.FundingThe National Institute for Health Research Health Technology Assessment programme.

show abstract

Enhancing infant attachment security: An examination of treatment efficacy and differential susceptibility

Cited by 179 publications

References 46 publications

Application of environmental sensitivity theories in personalized prevention for youth substance abuse: a transdisciplinary translational perspective

Application of environmental sensitivity theories in personalized prevention for youth substance abuse: a transdisciplinary translational perspective

Improving Outcomes for Children Exposed to Violence: Safe Start Promising Approaches

Clinical effectiveness and cost-effectiveness of parenting interventions for children with severe attachment problems: a systematic review and meta-analysis

Contact Info

Product

Resources

About