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Improving infants' stress-induced cortisol regulation through attachment-based intervention: A randomized controlled
Lisa J Berlin1, Tiffany L Martoccio2, Crystal I Bryce3
1University of Maryland School of Social Work, 525 West Redwood St., Baltimore, MD, 21201, United States.
Insights
Attachment-based parenting interventions, like Attachment and Biobehavioral Catch-up (ABC), improve infant cortisol regulation during stress. This enhances maternal sensitivity, benefiting infant physiological responses.
Area of Science:
- Developmental Psychology
- Behavioral Biology
- Pediatrics
Background:
- Attachment-based interventions show promise for early cortisol regulation.
- Previous research focused on diurnal cortisol in high-risk infants.
- The impact on stress-induced cortisol in typically developing infants is less understood.
Purpose of the Study:
- To test an enhanced Early Head Start (EHS) model combining home-based services with the Attachment and Biobehavioral Catch-up (ABC) intervention.
- To examine the intervention's effect on stress-induced cortisol production in low-income infants.
- To identify potential mediating mechanisms, such as maternal sensitivity.
Main Methods:
- A randomized controlled trial involving 153 low-income mothers and their infants (average age 12.4 months).
- Intervention group received home-based EHS plus ABC; control group received home-based EHS plus books.
- Intent-to-treat analyses used multilevel models to assess cortisol changes in response to mild stressors.
Main Results:
- A significant indirect intervention effect was found on infants' cortisol change rates during stress.
- The ABC intervention increased maternal sensitivity.
- Increased maternal sensitivity was linked to improved infant cortisol regulation, especially cortisol recovery rates.
Conclusions:
- The EHS plus ABC intervention effectively supports infants' stress-induced cortisol regulation.
- Sensitive maternal behavior is a key factor driving the intervention's positive effects on infant physiology.
- Attachment-based interventions hold preventative value by improving parenting and infant physiological regulation.
Abstract:
Attachment-based parenting interventions have shown positive effects on early cortisol regulation, a key biomarker. Evaluations to date have focused on diurnal cortisol production in high-risk infants. It is important to understand whether attachment-based intervention may also improve stress-induced cortisol production in typically developing infants. This randomized controlled trial tested an enhanced model of U.S. Early Head Start (EHS) services that combined home-based EHS with a brief, attachment-based parenting intervention, Attachment and Biobehavioral Catch-up (ABC). The trial included 153 low-income mothers and their infants (M age 12.4 months [SD = 4.1]). Control participants received home-based EHS plus 10 weekly books. Intent-to-treat analyses using multilevel models revealed a significant indirect intervention effect on infants' rates of cortisol change in response to a series of mild stressors. The intervention increased maternal sensitivity, which in turn improved cortisol regulation, particularly infants' rates of cortisol recovery. The findings illustrate the efficacy of EHS plus ABC for supporting infants' stress-induced cortisol regulation and implicate sensitive maternal behavior as the underlying driver of the intervention effect. Findings are discussed in terms of the preventative value of attachment-based parenting interventions that improve both parenting and infants' physiological regulation.