Attachment security in very low birth weight infants.

Mangelsdorf, Sarah C.; Plunkett, James; Dedrick, Cynthia F.; Berlin, Meryl; Meisels, Samuel J.; McHale, Jean L.; Dichtellmiller, Margo

doi:10.1037/0012-1649.32.5.914

Cited by 66 publications

(57 citation statements)

References 30 publications

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“…Interactions with parents may be compromised for premature infants for several reasons: the emotional response of parents to preterm birth, an altered parental role as a noncaregiver in the nursery, the infant's characteristics, the NICU environment and the prolonged parent-infant separation. [10][11][12][13][14][15][16][17][18][19] Early experience can modify the anatomy of the rapidly developing brain, 20 which implies that early intervention may alter developmental paths and improve health, educational and social outcomes. 21,22 This has prompted the use of early interventions for preterms, aimed at different targets in the complex interplay of biology and environment influencing development.…”

Section: Introductionmentioning

confidence: 99%

Early interventions involving parents to improve neurodevelopmental outcomes of premature infants: a meta-analysis

et al. 2009

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Objective: To determine in a systematic review, whether interventions for infant development that involve parents, improve neurodevelopment at 12 months corrected age or older.Study Design: Randomized trials were identified where an infant intervention was aimed to improve development and involved parents of preterms; and long-term neurodevelopment using standardized tests at 12 months (or longer) was reported.Result: Identified studies (n ¼ 25) used a variety of interventions including parent education, infant stimulation, home visits or individualized developmental care. Meta-analysis at 12 months (N ¼ 2198 infants) found significantly higher mental (N ¼ 2198) and physical (N ¼ 1319) performance scores favoring the intervention group. At 24 months, the mental (N ¼ 1490) performance scores were improved, but physical (N ¼ 1025) performance scores were not statistically significant. The improvement in neurodevelopmental outcome was not sustained at 36 months (N ¼ 961) and 5 years (N ¼ 1017). Conclusion:Positive clinically meaningful effects (>5 points) are seen to an age of 36 months, but are no longer present at 5 years.

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Section: Introductionmentioning

confidence: 99%

Early interventions involving parents to improve neurodevelopmental outcomes of premature infants: a meta-analysis

et al. 2009

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“…20 Preterm infants, especially those born with lower birth weights or greater medical risks, seem to be at risk for developing insecure attachments. [21][22][23] Insecure attachment is a nonspecific risk for later psychopathological conditions, [24][25][26] whereas attachment security is related to subsequent social competence and empathy. [27][28][29] The association between maternal grief resolution and attachment has been explored among children with diagnosed chronic medical conditions or disabilities by using the Reaction to Preterm Birth Interview (RPBI).…”

mentioning

confidence: 99%

Maternal Resolution of Grief After Preterm Birth: Implications for Infant Attachment Security

Shah

Clements²,

Poehlmann

2011

Pediatrics

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WHAT'S KNOWN ON THIS SUBJECT:For mothers of children with chronic medical conditions or disabilities, such as epilepsy or cerebral palsy, a history of maternal unresolved grief regarding the child's diagnosis has been associated with insecure infantmother attachment. WHAT THIS STUDY ADDS:Unresolved grief related to a preterm birth is associated with the development of insecure infantmother attachment. Mothers with resolved grief after preterm birth are 2.9 times as likely to have securely attached infants, compared with mothers with unresolved grief. abstract OBJECTIVE: This study explored the association between mothers' unresolved grief regarding their infant's preterm birth and infant-mother attachment security. We hypothesized that mothers with unresolved grief would be more likely to have insecurely attached infants at 16 months and that this association would be partially mediated by maternal interaction quality. METHODS:This longitudinal study focused on 74 preterm infants (age of Ͻ36 weeks) and their mothers who were part of a larger study of high-risk infants. The present analysis included assessment of neonatal and socioeconomic risks at NICU discharge; maternal depression, Reaction to Preterm Birth Interview findings, and quality of parenting at a postterm age of 9 months; and infant-mother attachment at postterm age of 16 months. Associations among findings of grief resolution with the Reaction to Preterm Birth Interview, quality of parenting interactions, and attachment security were explored by using relative risk ratios and logistic and multivariate regression models. RESULTS:The relative risk of developing insecure attachment when mothers had unresolved grief was 1.59 (95% confidence interval: 1.03-2.44). Controlling for covariates (adjusted odds ratio: 2.94), maternal feelings of resolved grief regarding the preterm birth experience were associated with secure infant-mother attachment at 16 months. Maternal grief resolution and interaction quality were independent predictors of attachment security. CONCLUSION:Maternal grief resolution regarding the experience of preterm birth and the quality of maternal interactions have important implications for emerging attachment security for infants born prematurely.

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“…Thirty-three studies were published between 1988 and 2011, of which the majority were undertaken in the USA (n = 18 24,47,93,94,[96][97][98][99][100][102][103][104]106,111,113,115,116,118,121 ), with the rest spread across the UK (n = 4 50,52,[107][108][109] ), Canada (n = 4 25,105,110,119 ), Germany (n = 2 101,122 ), the Netherlands (n = 2 117,120 ), Romania (n = 1 94 ) and Spain (n = 1 114 ). Table 1 and Box 1.…”

Section: Resultsmentioning

confidence: 99%

“…24,25,47,50,52,[93][94][95][96][99][100][101][102][104][105][106][107][108][111][112][113][114][115][116][117][118][119][120][121][122] In those studies providing demographic detail, parental age ranged from 12 to 70 years and ethnicity was predominantly white or Caucasian.…”

Section: Population Characteristicsmentioning

confidence: 99%

“…6 A total of 16 studies identified in this supplementary review used the SSP. 25,93,94,98,102,103,105,106,113,115,116,[118][119][120][121][122] Of these, six used the original ABC classification system 25,93,94,103,105,106 and 10 included the disorganised category in some form. 98,102,113,115,116,[118][119][120][121][122] This procedure has been very influential in the design of subsequent assessment tools, as evidenced by the development of many bespoke and modified versions of the procedure found in this review.…”

Section: The Strange Situation Proceduresmentioning

confidence: 99%

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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

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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.

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Attachment security in very low birth weight infants.

Cited by 66 publications

References 30 publications

Early interventions involving parents to improve neurodevelopmental outcomes of premature infants: a meta-analysis

Early interventions involving parents to improve neurodevelopmental outcomes of premature infants: a meta-analysis

Maternal Resolution of Grief After Preterm Birth: Implications for Infant Attachment Security

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

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