PREVENTIVE INTERVENTION WITH ANXIOUSLY ATTACHED INFANTS

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This proposal is a response to recent NIMH initiatives to encourage prevention research. It involves a study of early preventive intervention with anxiously attached 12-month old infants and their mothers. The aim is to reverse anxious attachment and to prevent the maladaptive patterns of social-emotional behavior found to be later correlates of anxious attachment in infancy. The sample will comprise 96 low SES, recent immigrant, socially isolated Latino mothers and their infants. Quality of attachment at 12 months will be assessed using a well-standardized instrument called the "strange situation". Measures of maternal childrearing attitudes, maternal responsiveness to the infant, quality of home environment and incidence of stressful life events will also be obtained. Anxiously attached infants will be randomly assigned to either a preventive intervention (experimental) group or to a non-intervention (control) group. A second control group will comprise securely attached infants and their mothers. Each group will contain 32 mother-infant dyads. Preventive intervention will consist of developmental guidance focused on mother-infant interaction and tailored to Latino childrearing values. Eight clusters (small groups) of 4 mother-infant dyads will meet weekly for 1 1/2 hours with a Latino cluster coordinator. The preventive intervention will last 12 months. The three research groups will be assessed at 18 months and 24 months. There are three main hypotheses. First, the preventive intervention group will have more adaptive scores in toddler and maternal measures than the anxiously attached control group when intervention ends at 24 months. Second, the preventive intervention group will not differ from the securely attached control group in toddler and maternal measures at 24 months. Third, the three groups will not differ in incidence of stressful life events at 24 months. Outcome measures at 24 months will be the child's social-emotional competence in solving a task, maternal responsiveness to the child, adaptiveness of maternal childrearing attitudes, quality of home environment, and incidence of stressful life events. Long-term objectives include: 1) developing a cost-effective method of preventive intervention in infancy; 2) building a data base on low SES, recent immigrant Latino mothers and their infants; and 3) assessing the needs of this population and the feasibility of culture-sensitive services in a county hospital setting.