Improving infants' stress-induced cortisol regulation through attachment-based intervention: A randomized controlled trial
Improving infants' stress-induced cortisol regulation through attachment-based intervention: A randomized controlled trial
复制标题
DOI：
10.1016/j.psyneuen.2019.01.005
复制
发表时间：
2019-05-01
影响因子：
3.7
通讯作者：
Harden, Brenda Jones
中科院分区：
文献类型：
--
作者：
Berlin, Lisa J.;Martoccio, Tiffany L.;Harden, Brenda Jones
基于依恋的育儿干预对早期皮质醇调节（一个关键的生物标志物）显示出积极的影响。迄今为止的评估主要集中在高危婴儿的皮质醇日生成。了解基于依恋的干预是否也可以改善典型发育婴儿应激诱导的皮质醇产生是很重要的。这项随机对照试验测试了美国早期开端（EHS）服务的增强模型，该服务将基于家庭的EHS与简短的、基于依恋的父母干预、依恋和生物行为追赶（ABC）相结合。该试验包括153名低收入母亲及其婴儿（年龄12.4个月[SD = 4.1]）。对照组接受家庭EHS，外加10本周报。使用多层次模型的意向治疗分析显示，在一系列轻度应激源的反应中，对婴儿皮质醇变化率有显著的间接干预作用。干预增加了母亲的敏感性，这反过来又改善了皮质醇的调节，特别是婴儿的皮质醇恢复率。本研究结果说明了EHS + ABC对婴儿应激诱导的皮质醇调节的支持作用，并暗示母亲的敏感行为是干预效果的潜在驱动因素。研究结果讨论了以依恋为基础的育儿干预措施的预防价值，这些干预措施可以改善育儿和婴儿的生理调节。
Attachment-based parenting interventions have shown positive effects on early cortisol regulation, a key biomarker. Evaluations to date have focused on diurnal cortisol production in high-risk infants. It is important to understand whether attachment-based intervention may also improve stress-induced cortisol production in typically developing infants. This randomized controlled trial tested an enhanced model of U.S. Early Head Start (EHS) services that combined home-based EHS with a brief, attachment-based parenting intervention, Attachment and Biobehavioral Catch-up (ABC). The trial included 153 low-income mothers and their infants (M age 12.4 months [SD = 4.1]). Control participants received home-based EHS plus 10 weekly books. Intent-to treat analyses using multilevel models revealed a significant indirect intervention effect on infants' rates of cortisol change in response to a series of mild stressors. The intervention increased maternal sensitivity, which in turn improved cortisol regulation, particularly infants' rates of cortisol recovery. The findings illustrate the efficacy of EHS plus ABC for supporting infants' stress-induced cortisol regulation and implicate sensitive maternal behavior as the underlying driver of the intervention effect. Findings are discussed in terms of the preventative value of attachment-based parenting interventions that improve both parenting and infants' physiological regulation.