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Associations between mother-preschooler attachment and maternal depression symptoms: A systematic review and meta-analysis.

ABSTRACT: The current study aimed to systematically review and meta-analyze concurrent and longitudinal associations between maternal depression symptoms and mother-child attachment during the preschool period (aged 2 to 7 years) as assessed using the coding systems by Cassidy and Marvin (1992) and Main and Cassidy (1988). The review was pre-registered with PROSPERO (International Prospective Register of Systematic Reviews; Registration number CRD42017073417) and was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A total of 7,969 records were screened and 18 articles were deemed as eligible for inclusion in the review. Studies were reviewed using qualitative synthesis techniques and, where appropriate, meta-analysis. Qualitative synthesis indicated that mothers of disorganized/controlling children most consistently reported the highest levels of depressive symptoms, both concurrently and longitudinally. The association between disorganized/controlling child attachment and concurrent maternal depressive symptoms was significant (n = 1,787; g = 0.27, 95% CI [0.13,0.40]), and was not moderated by sample type, child gender, or risk of bias. Findings of a relationship between child attachment insecurity and maternal depressive symptoms must be qualified due to significant within-study heterogeneity and publication bias. Results suggest that maternal depressive symptoms may confer risk for disorganized/controlling attachment during the preschool period.

PROVIDER: S-EPMC6168129 | BioStudies |

REPOSITORIES: biostudies

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Project description:Disorganized attachment is an important early risk factor for socioemotional problems throughout childhood and into adulthood. Prevailing models of the etiology of disorganized attachment emphasize the role of highly dysfunctional parenting, to the exclusion of complex models examining the interplay of child and parental factors. Decades of research have established that extreme child birth weight may have long-term effects on developmental processes. These effects are typically negative, but this is not always the case. Recent studies have also identified the dopamine D4 receptor (DRD4) as a moderator of childrearing effects on the development of disorganized attachment. However, there are inconsistent findings concerning which variant of the polymorphism (seven-repeat long-form allele or non-seven-repeat short-form allele) is most likely to interact with caregiving in predicting disorganized versus organized attachment. In this study, we examined possible two- and three-way interactions and child DRD4 polymorphisms and birth weight and maternal caregiving at age 6 months in longitudinally predicting attachment disorganization at 36 months. Our sample is from the Maternal Adversity, Vulnerability and Neurodevelopment project, a sample of 650 mother-child dyads. Birth weight was cross-referenced with normative data to calculate birth weight percentile. Infant DRD4 was obtained with buccal swabs and categorized according to the presence of the putative allele seven repeat. Macroanalytic and microanalytic measures of maternal behavior were extracted from a videotaped session of 20 min of nonfeeding interaction followed by a 10-min divided attention maternal task at 6 months. Attachment was assessed at 36 months using the Strange Situation procedure, and categorized into disorganized attachment and others. The results indicated that a main effect for DRD4 and a two-way interaction of birth weight and 6-month maternal attention (frequency of maternal looking away behavior) and sensitivity predicted disorganized attachment in robust logistic regression models adjusted for social demographic covariates. Specifically, children in the midrange of birth weight were more likely to develop a disorganized attachment when exposed to less attentive maternal care. However, the association reversed with extreme birth weight (low and high). The DRD4 seven-repeat allele was associated with less disorganized attachment (protective), while non-seven-repeat children were more likely to be classified as disorganized attachment. The implications for understanding inconsistencies in the literature about which DRD4 genotype is the risk direction are also considered. Suggestions for intervention with families with infants at different levels of biological risk and caregiving risk are also discussed.

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Associations between mother-preschooler attachment and maternal depression symptoms: A systematic review and meta-analysis.

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