Wittkowski A, Crompton C, Wan M W
School of Health Sciences, The University of Manchester, Manchester, UK.
Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.
Clin Child Fam Psychol Rev. 2025 Mar;28(1):71-100. doi: 10.1007/s10567-024-00497-0. Epub 2024 Nov 18.
As attachment-based interventions can improve caregiver-infant relationships and their subsequent psychological outcomes, the identification of relevant and effective interventions can facilitate their implementation into clinical practice. This systematic review aimed to a) provide an overview of manualised attachment-based interventions, without video-feedback as the main component, for caregivers and infants from conception to two years, and b) determine which of these interventions were effective in demonstrating improvements in caregiver-infant relational outcomes. To identify eligible interventions and their empirical evidence base, two search stages were conducted for 1) relevant interventions and 2) studies of interventions identified in the first stage that focussed on caregiver-infant relational outcomes. All studies included in Stage 2 were quality assessed and findings analysed. Twenty-six interventions were eligible for inclusion at Stage 1 but studies reporting on relational outcomes were identified for 16 interventions only. Forty studies reporting on those 16 interventions met inclusion criteria and were synthesised at Stage 2. Most studies were of good quality. Observer-rated measures were used in 90% of studies. There was evidence for these interventions in relation to improving caregiver-infant relational outcomes: 80% of studies reported a statistically significant positive change in a relational outcome for the intervention compared to pre-intervention or control group. The most promising evidence was identified for Attachment and Biobehavioral Catch-Up (ABC), Minding the Baby (MTB) and Circle of Security (COS). This systematic review offers guidance to healthcare professionals, commissioners and policymakers within perinatal sectors in relation to the training, delivery and implementation of evidenced manualised attachment-based interventions.
由于基于依恋的干预措施可以改善照顾者与婴儿之间的关系及其后续心理结果，因此识别相关且有效的干预措施有助于将其应用于临床实践。本系统评价旨在：a）概述从怀孕到两岁的照顾者和婴儿的、不以视频反馈为主要组成部分的、手册化的基于依恋的干预措施；b）确定这些干预措施中哪些能有效改善照顾者与婴儿的关系结果。为了识别符合条件的干预措施及其实证证据基础，进行了两个搜索阶段：1）相关干预措施；2）对第一阶段确定的、关注照顾者与婴儿关系结果的干预措施的研究。对纳入第二阶段的所有研究进行质量评估并分析结果。26项干预措施符合第一阶段的纳入标准，但仅16项干预措施有关于关系结果的报告。40项关于这16项干预措施的研究符合纳入标准并在第二阶段进行了综合分析。大多数研究质量良好。90%的研究使用了观察者评定的测量方法。有证据表明这些干预措施在改善照顾者与婴儿关系结果方面有效果：80%的研究报告称，与干预前或对照组相比，干预措施在关系结果上有统计学显著的正向变化。最有前景的证据是针对依恋与生物行为追赶（ABC）、关爱宝宝（MTB）和安全圈（COS）的。本系统评价为围产期领域的医疗保健专业人员、委托方和政策制定者在基于依恋的手册化干预措施的培训、提供和实施方面提供了指导。
