Parental reflective functioning (PRF) is an important predictor of infant attachment, and interventions that target parent–infant/toddler dyads who are experiencing significant problems have the potential to improve PRF. A range of dyadic interventions have been developed over the past two decades, some of which explicitly target PRF as part of their theory of change, and some that do not explicitly target PRF, but that have measured it as an outcome. However, no meta‐analytic review of the impact of these interventions has been carried out to date. The aim of this review was to evaluate the effectiveness of dyadic interventions targeting parents of infant and toddlers, in improving PRF and a number of secondary outcomes. A systematic review and meta‐analysis was conducted in which key electronic databases were searched up to October 2018. Eligible studies were identified and data extracted. Data were synthesised using meta‐analysis and expressed as both effect sizes and risk ratios. Six studies were identified providing a total of 521 participants. The results of six meta‐analyses showed a nonsignificant moderate improvement in PRF in the intervention group (standardised mean difference [SMD]: –0.46; 95% confidence interval [CI] [–0.97, 0.04]) and a significant reduction in disorganised attachment (risk ratio: 0.50; 95% CI [0.27, 0.90]). There was no evidence for intervention effects on attachment security (odds ratio: 0.71; 95% CI [0.19, 2.64]), parent–infant interaction (SMD: –0.10; 95% CI [–0.46, 0.26]), parental depression (SMD: –1.55; 95% CI [–3.74, 0.64]) or parental global distress (SMD: –0.19, 95% CI [–3.04, 22.65]). There were insufficient data to conduct subgroup analysis (i.e. to compare the effectiveness of mentalisation‐based treatment with non‐mentalization‐based treatment interventions). Relational early interventions may have important benefits in improving PRF and reducing the prevalence of attachment disorganisation. The implications for future research are discussed.

中文翻译：

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通过早期二元干预增强父母反思功能：系统评价和荟萃分析

父母反思功能 (PRF) 是婴儿依恋的重要预测指标，针对遇到重大问题的父母-婴儿/幼儿双人的干预措施有可能改善 PRF。在过去的 20 年中，已经开发了一系列二元干预措施，其中一些明确针对 PRF 作为其变革理论的一部分，而有些并未明确针对 PRF，但已将其作为结果进行衡量。然而，迄今为止，尚未对这些干预措施的影响进行荟萃分析。本综述的目的是评估针对婴幼儿父母的二元干预在改善 PRF 和许多次要结果方面的有效性。进行了系统评价和荟萃分析，其中搜索了截至 2018 年 10 月的关键电子数据库。确定了符合条件的研究并提取了数据。使用荟萃分析合成数据并表示为效应量和风险比。确定了六项研究，总共提供了 521 名参与者。六项荟萃分析的结果显示，干预组的 PRF 有不显着的中度改善（标准化平均差 [S​​MD]：–0.46；95% 置信区间 [CI] [–0.97, 0.04]）和无组织依恋的显着减少（风险比：0.50；95% CI [0.27, 0.90]）。没有证据表明干预对依恋安全性（优势比：0.71；95% CI [0.19, 2.64]）、亲子互动（SMD：–0.10；95% CI [–0.46, 0.26]）、父母抑郁（ SMD：–1.55；95% CI [–3.74, 0.64]) 或父母整体压力（SMD：–0.19, 95% CI [–3.04, 22.65]）。没有足够的数据进行亚组分析（即比较基于心理化的治疗与非基于心理化的治疗干预的有效性）。关系早期干预可能在改善 PRF 和减少依恋紊乱的流行方面具有重要的好处。讨论了对未来研究的影响。