The role of parental reflective functioning in promoting attachment for children of depressed mothers in a toddler-parent psychotherapeutic intervention

Abstract

Parental reflective functioning (PRF) refers to a parent's ability to interpret and reflect upon her child's mental states (e.g., thoughts, feelings, emotions, desires) and underlying behaviors, and relate them to her own thoughts, feelings, and behaviors (Slade, Bernbach, Grienenberger, Lev, & Locker, 2005a). The purpose of the present study was to explore the potential role of maternal reflective functioning in promoting attachment security among depressed mothers and their toddlers involved in a toddler-parent psychotherapy (TPP) intervention program. Children of depressed mothers have an increased likelihood of negative developmental outcomes, including disrupted attachment relationships with their primary caregivers (Cicchetti, Rogosch, & Toth, 1998). Toddler-parent psychotherapy has been demonstrated to significantly improve attachment security among this vulnerable population (Cicchetti, Toth, & Rogosch, 1999); however the mechanism underlying its efficacy is unclear. This study examined PRF and attachment status of 160 mother-toddler dyads. Among dyads, participant groups included: non-depressed control (NC) mothers (n = 62), depressed control (DC) mothers (n = 52), and depressed intervention (DI) mothers (n = 46) who participated in an 18 month TPP intervention program. Results showed no differences in PRF among the subject groups at either baseline or follow-up (post intervention) periods, suggesting no effect of TPP on PRF. Furthermore, results show that PRF does not account for the efficacy of TPP in improving attachment among toddlers of depressed mothers. PRF was, however, associated with educational attainment of mothers, regardless of participant group status. Research examining the construct of PRF is relatively new and therefore limited. Results of the present study are presented in light of previous research findings. The potential benefits and limitations of PRF as a construct, particularly for examining attachment and other developmental processes, are discussed.