Commentary on Guild et al. (2020): The Importance of Well-Designed Intervention Studies for Advancing Attachment Theory
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Commentary on Guild et al. (2020): The Importance of Well-Designed Intervention Studies for Advancing Attachment Theory and its Clinical Applications Catherine A. McMahon 1
&
Anne-Marie Maxwell 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Guild and colleagues (this issue) report results of a long-term follow up after a randomized trial of the effectiveness of an attachment-theory-informed psychotherapeutic intervention for mothers with depression and their toddlers. Their paper shows the intervention can increase the likelihood of secure attachment in children of depressed mothers and that secure attachment explains more optimal social-emotional functioning in middle childhood in the treated group. This commentary discusses the contribution of the paper by Guild and colleagues and their broader body of work to our evolving understanding of developmental processes underpinning social-emotional competence in children of depressed parents, and to several ongoing controversies in the field: 1) the relevance of attachment-theory-informed interventions in the context of maternal depression; 2) the evidence gap regarding the efficacy and effectiveness of attachment-theoryinformed interventions, particularly with respect to sustained benefits; 3) cost-benefits of early interventions; and 4) the need for theory driven research that explains how and under what circumstances attachment is related to later child outcomes. Keywords Maternal depression . Attachment security . Child parent psychotherapy . Maternal warmth . Child behavior problems
Children of depressed mothers are at increased risk of insecure attachment and compromised functioning in social-emotional domains of development (Goodman and Gotlib 1999; Wan and Green 2009). Insecure attachment is an important but non-specific risk factor for developmental psychopathology (DeKlyen and Greenberg 2016). It makes sense, therefore, to intervene early with depressed parents to try to ensure a more positive developmental trajectory for their children. Overall, however, the body of literature linking maternal depression, insecure mother-child attachment and problematic child outcomes presents a mixed and complex story. Further, there is ongoing debate about the extent to which insecure attachment is a risk factor for developmental psychopathology (DeKlyen and Greenberg 2016; Meins 2017; Thompson 2016), and limited empirical evidence demonstrating how
* Catherine A. McMahon [email protected] 1
Centre for Emotional Health, Department of Psychology, Macquarie University, North Ryde, NSW 2109, Australia
secure attachment influences later development (Thompson 2016). The paper by Guild and colleagues in this issue, together with earlier reports from this group of researchers, provides a compelling body of evidence that an attachment-theoryinformed psychotherapeutic intervention for new mothers with depression can increase the likelihood of secure attachment in their children. Importantly, the shift to secure attachment explains bett
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