Attachment security mediates the longitudinal association between child-parent psychotherapy and peer relations for toddlers of depressed mothers

Abstract

Numerous investigations have demonstrated that child-parent psychotherapy (CPP) promotes secure attachment between mothers and offspring. However, the role of postintervention attachment security as it relates to long-term child outcomes has never been evaluated. The present study therefore examined postintervention attachment status as a mediator of the association between CPP for depressed mothers and their offspring and subsequent peer relations among offspring. Depressed mothers and their toddlers were randomized to receive CPP (n = 45) or to a control group (n = 55). A prior investigation with this sample indicated that offspring who received CPP attained significantly higher rates of secure attachment postintervention, whereas insecure attachment continued to predominate for offspring in the control group. The present study examined follow-up data of teachers' reports on participants' competence with classroom peers when they were approximately 9 years old. Findings indicated that children who received CPP were more likely to evidence secure attachments at postintervention, which in turn was associated with more positive peer relationships at age 9.

Figure 1

Path model denoting standardized estimates of the direct and indirect pathways for the association between CPP, attachment security, and peer relationships across time. Standard errors are in parentheses. To remain consistent with the WLSMV estimation technique, exogenous variables were left uncorrelated. Dashed pathways are nonsignificant. *p < .05, **p ≤ .01, ***p ≤ .001