Entropy Rules

Interrupt Cycle:

Intergenerational Solidarity To End Maltreatment

    Given the enormous amount of risk associated with child maltreatment, it is important to examine how and under what circumstances indicators of child maltreatment, such as a insecure attachment styles, could change, both intra- and intergenerationally. One study examined how attachment styles fluctuated from infancy to early adulthood in a high-risk sample (Weinfield, Sroufe, and Egeland, 2000). The most common change in attachment status in this sample was a move from secure attachment in infancy to an insecure attachment style in childhood or adolescence. The transition from security to insecurity was associated with a high instance of negative life events including being born to a single mother, experiencing parental divorce or the life-threatening illness of the parent or child, a serious drug or alcohol problem with parent or child, child physical or sexual abuse, and parent or custodial attachment figure death. Most participants (91.2%) in this high-risk sample reported such an event. The link between such stressors and development of insecure attachment later in life was related to family dynamics. Additionally, for individuals who were insecurely attached as infants, maltreatment predicted maintenance of attachment insecurity over time. A minority of participants found to be initially insecure transitioned to security. Those that transitioned to security had better family functioning at age 13, demonstrating more cooperative, collaborative, and contingent communication that struck a better balance of all family members' needs and whole family needs. In contrast, individuals who transitioned from security to insecurity were more likely to have mothers with depressive symptoms compared to stable, secure individuals. Life stress, lack of social support, depression, divorce, poor family functioning, and features of the home environment all played a role in this intragenerational shift, that can problematize an adult's state of mind with respect to attachment even when early experiences with caregivers were "good-enough" (Weinfeld et al., 2000).
    Bakermans-Kranenburg, Van Ijzendoorn, and Juffer (2005) conducted a narrative review and meta-analysis of 10 studies involving 15 interventions intended to enhance attachment security among mainly at-risk parents and infants. The results of these studies were mixed with some studies showing some benefit in terms of increasing maternal sensitivity or decreasing disorganized attachment rates, while other studies showed no effect or appeared to increase rates of disorganization. The collective effect size for these interventions was nonsignificant. However, individual interventions tended to be more effective when they targeted parents and infants greater than 6 months of age (as opposed to younger than 6 months of age). Interventions that used trained interventionists and home visits were more likely to be effective than interventions targeting maternal mental representations or social support through educational materials. Studies involving at-risk children (e.g., adopted, premature) with low-risk parents were more effective than studies involving parents with characteristics that place them at higher risk for engaging in child maltreatment.
    Bernard and colleagues (2012) developed and tested an intervention designed to decrease rates of disorganized attachment in families at risk of maltreatment. The Attachment and Biobehavioral Catch-up (ABC) intervention, a manualized, 10-session, in-home behavioral intervention, aims to increase nurturance in response to child distress, increase parental interest and attentiveness in the absence of child-distress (i.e., following the child's lead), and decrease frightening behavior. The ABC intervention was applied to a group of parents and children involved with child protective services and thus deemed to be at high-risk of disorganized attachment. Compared to an active control intervention, children in the ABC group showed significantly lower rates of disorganized attachment and significantly higher rates of secure attachment (Bernard et al., 2012).
    Other studies have identified the presence of alternative, emotionally supportive relationships, such as with a therapist, as being central in the adult survivors of child maltreatment's process of attaining earned-security (e.g., Saunders, Jacobvitz, Zaccagnino, Beverung, & Hazen, 2011). Studies have found safe, stable, and nurturing relationships with romantic partners and/or children to be protective against perpetrating child maltreatment into the next generation (Conger, Schofield, Neppel, & Merrick, 2013; Thornberry & Henry, 2013). Depending on the extent of emotional dysregulation and underdevelopment of social emotional skills, however, it may be difficult for adult survivors of child maltreatment to find and maintain such relationships.
    Considered together, disrupting the formation of disorganized attachment especially in those contexts most likely to breed disorganization appears to be a daunting clinical challenge. A take home messages from the Bakersmanns-Kranenbug and colleagues (2005) meta-analysis appears to be that simply exposing parents to information about better parenting doesn't prevent disorganization, but interventions that focus on and promote behavior change with the assistance of trained interventionists are on the right track. Importantly changes from insecurity to security, both intra and intergenerationally, are associated with good social-emotional functioning, such as balanced, effective communication and safe, stable, and nurturing relationships (e.g., Conger, Schofield, Neppel, & Merrick, 2013;), while transition from security to insecurity is associated with risk factors associated with parental mental health and environmental risk (Weinfield et al., 2000).
    These (mostly ineffective) non mindfulness-based interventions are designed in a way that fails to consider the nature of the types of parental behavior that result in disorganization, which we understand to involve frightening or frightened behavior, intrusiveness, unpredictability, and withdrawal that occurs in an emotionally dysregulated state (e.g., Hesse, Main, Yost, & Rifkin, 2003). The presence of a home interventionist may help the parent remain regulated. When regulated, the parent may have access to good parenting skills. However, these skills may not be accessible to the parent when in a dysregulated state, which may be less likely to occur in the presence of an interventionist. The role of emotion regulation may account for the success of Bernard and colleagues (2012) intervention that specifically focused on reducing frightening parental behavior. The success of the didactic structure of such interventions relies on parents prefrontal cognitive functioning, but this tends to be off-line if the survivor parent is in a triggered, disintegrated state. Succinctly put, these interventions are not targeting the mechanisms that give rise to problematic parenting. Mindfulness, however, may have the ability to target and develop the neurological, cognitive, and affective processes involved in emotion and behavior regulation. Mindfulness training may be a crucial addition to parenting interventions, especially in adult survivors of child maltreatment who may have emotion regulation deficits.

⇲ About The Author

Robin Hertz, MA is currently in the process of completing a PhD in Clinical Psychology at the University of Oregon.