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Cited by 87Attachment and Relationship DynamicsPsychoanalysis and Psychopathology ResearchMaternal Mental Health During Pregnancy and Postpartum

NARRATIVE AND META-ANALYTIC REVIEW OF INTERVENTIONS AIMING TO IMPROVE MATERNAL-CHILD ATTACHMENT SECURITY: Narrative and Meta-Analytic Review of Infant Attachment Interventions

Letourneau, Nicole, Tryphonopoulos, Panagiota, Giesbrecht, Gerald, Dennis, Cindy-Lee, Bhogal, Sanjit, Watson, Barry·2015·Infant Mental Health Journal
DOI 10.1002/imhj.21525
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Abstract

Early secure maternal-child attachment relationships lay the foundation for children's healthy social and mental development. Interventions targeting maternal sensitivity and maternal reflective function during the first year of infant life may be the key to promoting secure attachment. We conducted a narrative systematic review and meta-analysis to examine the effectiveness of interventions aimed at promoting maternal sensitivity and reflective function on maternal-child attachment security, as measured by the gold standard Strange Situation (M. Ainsworth, M. Blehar, B. Waters, & S. Wall, 1978) and Q-set (E. Waters & K. Deane, 1985). Studies were identified from electronic database searches and included randomized or quasi-randomized controlled parallel-group designs. Participants were mothers and their infants who were followed up to 36 months' postpartum. Ten trials, involving 1,628 mother-infant pairs, were included. Examination of the trials that provided sufficient data for combination in meta-analysis revealed that interventions of both types increased the odds of secure maternal-child attachment, as compared with no intervention or standard intervention (n = 7 trials; odds ratio: 2.77; 95% confidence interval: 1.69, 4.53, n = 965). Of the three trials not included in the meta-analyses, two improved the likelihood of secure attachment. We conclude that interventions aimed at improving maternal sensitivity alone or in combination with maternal reflection, implemented in the first year of infants' lives, are effective in promoting secure maternal-child attachments. Intervention aimed at the highest risk families produced the most beneficial effects.

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  • Attachment-based approaches that strengthen caregiver attentiveness and reflective functioning during the postpartum period have been associated with improved attachment outcomes in high-risk families, which may reduce downstream developmental vulnerability.

    “Attachment-based approaches that strengthen caregiver attentiveness and reflective functioning during the postpartum period have been associated with improved attachment outcomes in high-risk families, which may reduce downstream developmental vulnerability (127).”

    From Epigenetic changes associated with multi-generational trauma: characterization, mechanisms, and therapeutics (2026) · cites this paper as [127]

  • Prevention and treatment approaches tend to span multiple levels, including trauma-focused therapy, attachment and relationship-based interventions, and broader strategies that support regulation through sleep, stress management, and health behaviors.

    “Prevention and treatment approaches therefore tend to span multiple levels, including trauma-focused therapy, attachment and relationship-based interventions, and broader strategies that support regulation through sleep, stress management, and health behaviors (19, 125–135).”

    From Epigenetic changes associated with multi-generational trauma: characterization, mechanisms, and therapeutics (2026) · cites this paper as [127]

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Authors
Letourneau, N., Tryphonopoulos, P., Giesbrecht, G., Dennis, C.-L., Bhogal, S., & Watson, B.
Affiliations
  • University of Calgary (CA)
  • University of New Brunswick (CA)
  • Alberta Children's Hospital (CA)
  • University of Toronto (CA)
Corresponding author
Letourneau, Nicole
ORCID
Venue
Infant Mental Health Journal
Publisher
Wiley
Published
2015-06-25
Volume
36
Issue
4
Pages
366-387
ISSN
0163-9641 (ISSN-L)
DOI
10.1002/imhj.21525
OpenAlex
W1490686782
Cited by
87
References
80
Citations by year
2026: 9 · 2025: 9 · 2024: 11 · 2023: 4 · 2022: 8 · 2021: 13 · 2020: 9 · 2019: 5 · 2018: 12 · 2017: 4 · 2016: 3
FWCI
0.99
Type
journal article
Language
en
Open access
closed
Licence
doi.wiley.com/10.1002/tdm_license_1.1 (tdm, 68 d)
Locations
  • Infant Mental Health Journal (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Social Psychology › Attachment and Relationship Dynamics
  • Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
Keywords
secure attachment, maternal sensitivity, attachment-based intervention, infant mental health, Strange Situation, Q-sets, postpartum women, high-risk families, early infancy
MeSH terms
Child, Preschool, Female, Humans, Infant, Maternal Behavior, Mother-Child Relations, Mothers, Object Attachment, Randomized Controlled Trials as Topic, Parenting

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