Toxic stressors (e.g., parental violence, depression, low income) place children at risk for insecure attachment. Parental reflective function—parents’ capacity to understand their own and their child's mental states and thus regulate their own feelings and behavior toward their child—may buffer the negative effects of toxic stress on attachment. Our objective was to test the effectiveness of the Attachment and Child Health (ATTACH) intervention, focusing on improving reflective function and children's attachment security, for at‐risk mothers and children <36 months of age. Three pilot studies were conducted with women and children from an inner city agency serving vulnerable, low‐income families and a family violence shelter. Randomized control trial (n = 20, n = 10 at enrollment) and quasi‐experimental (n = 10 at enrollment) methods tested the effect of the ATTACH intervention on the primary outcome of reflective function scores, from transcribed Parent Development Interviews. Our secondary outcome was children's attachment patterns from Ainsworth's Strange Situation Procedure. Despite some attrition, mixed methods analysis of covariance and t tests revealed significant differences in maternal, child, and overall reflective function, with moderate effect sizes. While more children whose mothers received the ATTACH program were securely attached posttreatment, as compared with controls, significant differences were not observed, which may be due to missing observations (n = 5 cases). Understanding the effectiveness of programs like the ATTACH intervention contributes to improved programs and services to promote healthy development of children affected by toxic stress.

中文翻译：

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依恋与儿童健康（ATTACH）试点试验：父母反射功能干预对受毒应激影响的家庭的影响。

有毒的压力源（如父母暴力，抑郁，低收入）使儿童处于不安全依恋的危险中。父母的反思功能（父母理解自己和孩子的心理状态，从而调节自己对孩子的感觉和行为的能力）可以减轻有毒压力对依恋的负面影响。我们的目标是测试依恋和儿童健康（ATTACH）干预措施的有效性，重点是为处于危险中的母亲和36个月以下的儿童改善反射功能和儿童依恋的安全性。对来自一个内部城市机构的妇女和儿童进行了三项试点研究，这些机构为弱势，低收入家庭和家庭暴力庇护所服务。随机对照试验（n = 20，n在入组时= 10）和在实验中（入组n = 10）方法通过转录的“父母成长访谈”测试了ATTACH干预对反射功能评分主要结果的影响。我们的次要结果是来自Ainsworth的“陌生情况程序”的儿童依恋模式。尽管有一些消耗，但协方差和t检验的混合方法分析显示，母体，儿童和整体反射功能存在显着差异，且效应大小适中。尽管有更多的儿童的母亲接收的ATTACH程序被牢固地附接后处理，与对照组相比，显著差异，未观察到，这可能是由于缺少观测（Ñ= 5例）。了解诸如ATTACH干预之类的计划的有效性有助于改进计划和服务，以促进受毒物胁迫影响的儿童的健康成长。