Attachment and Affect between Mothers with Depression and their Children: Longitudinal Outcomes of Child Parent Psychotherapy

Danielle J. Guild, Michelle E. Alto, Elizabeth D. Handley, Fred Rogosch, Dante Cicchetti, Sheree L. Toth

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


The present investigation examined the longitudinal effects of Child-Parent Psychotherapy (CPP) for toddlers and their mothers with depression on: a) maternal affective expression, b) child affective expression, and c) mother-child cohesion. Mothers with depression (Mage = 31.7 years; 92.8% White, 3.5% Black, 2.1% Hispanic, 2.3% other) and their toddlers were randomized to receive CPP (DI; n = 66) or to a control group (DC; n = 64). Mothers without depression and their toddlers (NC; n = 68) were recruited as an additional comparison group. Dyads were assessed at baseline (T1; 20 months old), post-intervention (T2; 36 months old), and follow-up (T3; 9 years old). Data from a mother-child conflict task was coded as a measure of observed outcome variables. Change in post-intervention attachment security assessed via the Strange Situation was evaluated as a mediator between intervention condition and maternal and child affective expression and dyadic cohesion at T3. Change to secure attachment post-intervention significantly mediated the association between intervention condition and T3 maternal warmth and child anger/problem behavior. Toddlers of mothers with depression who received CPP showed higher rates of change to secure attachment compared to those in both the DC and NC groups. Dyads who changed to secure attachment at T2 displayed higher levels of maternal warmth at T3 and lower levels of child anger and problem behavior at T3. Implications for the use of CPP as a preventive intervention and the importance of attachment as a mediator of long-term outcomes are discussed.

Original languageEnglish (US)
Pages (from-to)563-577
Number of pages15
JournalResearch on Child and Adolescent Psychopathology
Issue number5
StatePublished - May 2021

Bibliographical note

Funding Information:
This work was supported by the NIMH under Grant R01 MH45027. Anna Defayette, M.A., served as a reliability coder of mother-child interactions.

Publisher Copyright:
© 2021, Springer Science+Business Media, LLC, part of Springer Nature.


  • Attachment intervention
  • Child affect
  • Child parent psychotherapy
  • Maternal affect
  • Maternal depression


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