Increasing maternal sensitivity to infant distress through attachment-based intervention: a randomized controlled

Allison D Hepworth1, Lisa J Berlin1, Katrieana Salas1

  • 1University of Maryland School of Social Work, Baltimore, MD, USA.

Maternal sensitivity to infant distress is a key predictor of infant attachment security and social-emotional development. Preventive interventions that support mothers' sensitive responses to infant distress are crucial, as are rigorous evaluations that test for whom such interventions are effective. The current randomized controlled trial tested main and moderated effects of an attachment-based intervention on mothers' sensitivity to their infants' distress in 161 low-income, predominantly Latino mother-infant dyads. We tested the brief (10-session) Attachment and Biobehavioral Catch-up (ABC) intervention in the context of home-based federal Early Head Start services. An intent-to-treat analysis with covariates revealed a positive main intervention effect on maternal sensitivity to distress following a brief novel and potentially fear-inducing procedure (d = 0.32). The intervention effect was not moderated by mothers' self-reported attachment security, avoidance, or anxiety. Findings are discussed in terms of the value and feasibility of increasing maternal sensitivity to infant distress through attachment-based intervention.

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Attachment is vital for infant development, as warm social interactions support growth and well-being. In a classic 1958 study by Harry Harlow, the significance of warmth and comfort in forming attachments was examined. Harlow separated newborn monkeys from their mothers and provided two artificial "mothers": one made of cold wire and the other covered in soft cloth. Despite the wire mother offering food, the infant monkeys preferred the comfort of the cloth mother, demonstrating that...
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