Review: Attachment and attachment-related outcomes in preschool children - a review of recent evidence

Jane Barlow; Anita Schrader-McMillan; Nick Axford; Zoe Wrigley; Shreya Sonthalia; Tom Wilkinson; Michaela Rawsthorn; Alex Toft; Jane Coad

doi:10.1111/camh.12138

Review: Attachment and attachment-related outcomes in preschool children - a review of recent evidence

Child Adolesc Ment Health. 2016 Feb;21(1):11-20. doi: 10.1111/camh.12138. Epub 2015 Nov 25.

Authors

Jane Barlow¹, Anita Schrader-McMillan¹, Nick Axford², Zoe Wrigley², Shreya Sonthalia², Tom Wilkinson², Michaela Rawsthorn², Alex Toft³, Jane Coad³

Affiliations

¹ Health Services Research Unit, Warwick Medical School, University of Warwick, Medical School Building, Gibbet Hill Road, Coventry, CV4 7AL, UK.
² Dartington Social Research Unit, Totnes, UK.
³ Centre for Children and Families Applied Research (CCFAR), Coventry University, Coventry, UK.

PMID: 32680362
DOI: 10.1111/camh.12138

Abstract

Background: Secure attachment is associated with optimal outcomes across all domains in childhood, and both insecure and disorganised attachment are associated with a range of later psychopathologies. Insecure and disorganised attachment are common, particularly in disadvantaged populations, pointing to the need to identify effective methods of addressing such problems.

Aims: This paper presents the findings of a review of secondary and primary studies evaluating the effectiveness of interventions aimed at improving attachment and attachment-related outcomes on a universal, targeted or indicated basis, which was undertaken as part of an update of the evidence base for a UK-based national programme targeting children aged 0-5 years (Healthy Child Programme).

Method: A systematic search of key electronic databases was undertaken to identify secondary and primary sources of data that addressed the research question and that had been published between 2008 and 2014; search sources included Cochrane Collaboration, NICE, EPPI Centre, Campbell Collaboration and PubMed, PsychInfo, CINAHL databases.

Findings: Six systematic reviews and 11 randomised controlled trials were identified that had evaluated the effectiveness of universal, selective or indicated interventions aimed at improving attachment and attachment-related outcomes in children aged 0-5 years. Potentially effective methods of improving infant attachment include parent-infant psychotherapy, video feedback and mentalisation-based programmes. Methods that appear to be effective in improving attachment-related outcomes include home visiting and parenting programmes.

Conclusions: A number of methods of working to promote attachment and attachment-related outcomes in preschool children are now being recommended as part of the Healthy Child Programme. The implications in terms of the role and contribution of practitioners working in child and adolescent mental health service are discussed.

Keywords: 0-5 years; Healthy Child Programme; attachment; early years; intervention; parental sensitivity.

Publication types

Review

Grants and funding

Public Health England