Maltreated Children in Out-of-Home Care: The Relation between Attachment Quality and Internalizing Symptoms

Ashley A. Chesmore, Lindsey M. Weiler, Lisa J. Trump, Ashley L. Landers, Heather N. Taussig

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7 Scopus citations


Maltreated children in out-of-home care are at high risk for poor relationships with caregivers (i.e., biological parents and substitute caregivers) and high levels of internalizing symptoms. It is unclear if these poor relationships are related to, and account for a large portion of the variance in maltreated children’s internalizing symptoms, above and beyond maltreatment type and out-of-home care factors. This study examined the relation between attachment quality with both biological parents and substitute caregivers and children’s internalizing symptoms within a sample of 493 maltreated children (aged 9–11; 51.0 % male) recently placed in out-of-home care. A series of hierarchical regression models indicated that greater child-reported attachment quality with both biological parents and substitute caregivers was associated with fewer child-reported anxiety (β = −.15, p <.01; β = −.29, p <.001, respectively) and depression symptoms (β = −.14, p <.01; β = −.28, p <.001, respectively) as well as fewer child internalizing symptoms (β = −.12, p <.05; β = −.14, p <.01, respectively). Attachment quality with the biological parent and substitute caregiver each explained a significant proportion of the variance in children’s internalizing symptoms, above and beyond child demographics, maltreatment type, and out-of-home care variables. The study also examined whether children’s attachment with substitute caregivers moderated the relationship between children’s attachment with biological parents and children’s internalizing symptoms. No statistically significant moderation effects were found. Future clinical work should focus on enhancing attachment quality between children and both biological parents and substitute caregivers, as these relationships appear to individually relate to the children’s internalizing symptomology.

Original languageEnglish (US)
Pages (from-to)381-392
Number of pages12
JournalJournal of Child and Family Studies
Issue number2
StatePublished - Feb 1 2017

Bibliographical note

Funding Information:
This project was principally supported by grants from the National Institute of Mental Health (1 K01 MH01972, 1 R21 MH067618, and 1 R01 MH076919, H. Taussig, PI) and also received substantial funding from the Kempe Foundation, Pioneer Fund, Daniels Fund, and Children’s Hospital Research Institute. Dr. Weiler was supported by USPHS grant T32 MH15442, “Development of Psychopathology, Psychobiology & Behavior” (UCD Institutional Postdoctoral Research Training Program). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Publisher Copyright:
© 2016, Springer Science+Business Media New York.


  • Attachment
  • Foster care
  • Internalizing symptoms
  • Maltreatment
  • Preadolescents


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