Poverty and InequalitySexual and Reproductive HealthFamily, Maternal & Child HealthMethodology

Examining Maternal Depression and Attachment Insecurity as Moderators of the Impacts of Home Visiting for At-Risk Mothers and Infants

TitleExamining Maternal Depression and Attachment Insecurity as Moderators of the Impacts of Home Visiting for At-Risk Mothers and Infants
Publication TypeJournal Article
Year of Publication2009
AuthorsDuggan, AK, Berlin, LJ, Cassidy, J, Burrell, L, Tandon, SD
JournalJournal of Consulting and Clinical Psychology
ISBN Number0022006X (ISSN)
KeywordsAdolescent, Adult, adult attachment, Alaska, anxiety, article, child abuse, child parent relation, Child, Preschool, Community Mental Health Services, controlled study, Dependency (Psychology), dependent personality disorder, depression, Depression, Postpartum, emotional attachment, Female, Follow-Up Studies, high risk patient, Home visiting, House Calls, human, Humans, Infant, major clinical study, Male, maternal depression, Mother-Child Relations, Object Attachment, outcome assessment, parental stress, Parenting, Partner violence, pregnancy complication, professional practice, Program Development, psychometry, Randomized Controlled Trials as Topic, Risk Assessment, Risk Factors, Self Report, Social Environment, social psychology, social welfare, substance abuse, trust, United States, Young Adult

Home visiting programs for at-risk mothers and their infants have proliferated nationally in recent years, yet experimental studies of home visiting have yielded mixed findings. One promising strategy for explicating the effects of early home visiting is to examine moderators of program impacts. This study assessed the roles of maternal depression and attachment insecurity as moderators of the impacts of Healthy Families Alaska home visiting services for at-risk mothers and their infants. At-risk families (N = 325) were randomly assigned to home visiting or community services as usual (n = 162 and 163, respectively). Maternal depression and attachment insecurity (attachment anxiety and discomfort with trust/dependence) were measured at baseline. Maternal psychosocial and parenting outcomes were measured when children were 2 years old via maternal self-report, observation, and review of substantiated reports of child maltreatment. Maternal depression and attachment insecurity interacted in their moderation of program impacts. For several outcomes, home visiting impacts were greatest for nondepressed mothers with moderate-to-high discomfort with trust/dependence and for depressed mothers with low discomfort with trust/dependence. Implications for practice and policy are discussed. © 2009 American Psychological Association.